Published online Jul 21, 2015. doi: 10.3748/wjg.v21.i27.8441
Peer-review started: January 12, 2015
First decision: March 10, 2015
Revised: March 25, 2015
Accepted: May 7, 2015
Article in press: May 7, 2015
Published online: July 21, 2015
AIM: To perform a systematic review and meta-analysis on robotic-assisted vs laparoscopic liver resections.
METHODS: A systematic literature search was performed using PubMed, Scopus and the Cochrane Library Central. Participants of any age and sex, who underwent robotic or laparoscopic liver resection were considered following these criteria: (1) studies comparing robotic and laparoscopic liver resection; (2) studies reporting at least one perioperative outcome; and (3) if more than one study was reported by the same institute, only the most recent was included. The primary outcome measures were set for estimated blood loss, operative time, conversion rate, R1 resection rate, morbidity and mortality rates, hospital stay and major hepatectomy rates.
RESULTS: A total of 7 articles, published between 2010 and 2014, fulfilled the selection criteria. The laparoscopic approach was associated with a significant reduction in blood loss and lower operative time (MD = 83.96, 95%CI: 10.51-157.41, P = 0.03; MD = 68.43, 95%CI: 39.22-97.65, P < 0.00001, respectively). No differences were found with respect to conversion rate, R1 resection rate, morbidity and hospital stay.
CONCLUSION: Laparoscopic liver resection resulted in reduced blood loss and shorter surgical times compared to robotic liver resections. There was no difference in conversion rate, R1 resection rate, morbidity and length of postoperative stay.
Core tip: No consensus is available in the literature about which technique between laparoscopic and robotic liver resection is more beneficial to the patient. This is the first systematic review and meta-analysis comparing laparoscopic and robotic liver resection. We investigated these two techniques in terms of estimated blood loss, operative time, conversion rate, R1 resection rate, morbidity and mortality rates, hospital stay and major hepatectomy rates.