Department of Surgery, Dong-A University College of Medicine, Dong-A University Medical Center, 26 Daesingongwon-ro, Seo-gu, Busan, 49201, Republic of Korea.
J Robot Surg. 2024 Apr 29;18(1):187. doi: 10.1007/s11701-024-01901-1.
The transition from open hepatectomy to minimally invasive techniques has reduced morbidity and mortality. However, laparoscopic liver resection (LLR) requires substantial expertise. Robotic liver resection (RLR) combines minimal invasiveness with open surgical precision. It may facilitate complex procedures without the learning required for LLR. We evaluated RLR outcomes in a limited resource setting and assessed its efficacy and practicality. This retrospective study analyzed 67 robotic hepatectomies conducted from 2020 to 2023. Demographic, perioperative factors, and surgical outcomes were analyzed. Major hepatectomies were required in 46/67 (68.7%) patients who underwent RLR. No open conversions, 30-day mortalities, or readmissions occurred. Complications occurred in 7.4% of patients; major complications occurred in 5.9%. Learning curve analysis showed a negative correlation between operation sequence and operative time. Effective use of robotic technology combined with the expertise of well-trained surgeons facilitates successful execution of RLR with feasible surgical outcomes, even at smaller centers.
从开腹肝切除术向微创技术的转变降低了发病率和死亡率。然而，腹腔镜肝切除术 (LLR) 需要大量的专业知识。机器人肝切除术 (RLR) 将微创性与开腹手术的精确性相结合。它可以促进复杂手术的开展，而无需像 LLR 那样进行学习。我们在资源有限的环境中评估了 RLR 的结果，并评估了其疗效和实用性。这项回顾性研究分析了 2020 年至 2023 年间进行的 67 例机器人肝切除术。分析了人口统计学、围手术期因素和手术结果。46/67 (68.7%)接受 RLR 的患者需要进行大肝切除术。没有开腹转换、30 天死亡率或再入院。7.4%的患者发生并发症；主要并发症发生在 5.9%。学习曲线分析显示手术顺序与手术时间呈负相关。机器人技术的有效使用结合经验丰富的外科医生的专业知识，即使在较小的中心，也可以成功实施 RLR，并获得可行的手术结果。
