Khan Mohammed Azeem, Mahakalkar Chandrashekhar, Kshirsagar Shivani, Dhole Simran, Dixit Sparsh
General Surgery, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND.
Cureus. 2024 Aug 20;16(8):e67262. doi: 10.7759/cureus.67262. eCollection 2024 Aug.
Minimally invasive liver surgery, particularly hepatectomy, has evolved significantly with the advent of laparoscopic and robotic techniques. These approaches offer potential benefits over traditional open surgery, including reduced postoperative pain, shorter hospital stays, faster recovery, and improved cosmetic outcomes. This comprehensive review aims to compare the operative efficiency and postoperative recovery outcomes of robotic and laparoscopic hepatectomy. It seeks to provide an in-depth analysis of the advantages and limitations of each technique, assess their cost-effectiveness, and explore emerging trends and future directions in minimally invasive liver surgery. A comprehensive literature search was conducted to identify studies comparing robotic and laparoscopic hepatectomy. The review includes an analysis of operative time, intraoperative blood loss, conversion rates, postoperative pain, length of hospital stay, complication rates, oncological outcomes, and overall cost. Additionally, advancements in technology and future research directions were explored to provide a comprehensive overview of the current landscape and future potential of these surgical techniques. Both robotic and laparoscopic hepatectomy have demonstrated comparable outcomes in terms of oncological safety and effectiveness. However, robotic hepatectomy offers advantages in terms of precision and dexterity, particularly in complex cases, due to its advanced visualization and instrumentation. Laparoscopic hepatectomy, while associated with shorter operative times and lower costs, is limited by technical challenges, especially in major liver resections. The review also highlights the increasing adoption of robotic systems, despite their higher costs and the need for specialized training. Robotic and laparoscopic hepatectomy are both viable options for minimally invasive liver surgery, each with distinct advantages and limitations. The choice between the two should be based on patient-specific factors, the complexity of the procedure, and the surgeon's expertise. Ongoing advancements in technology, including the integration of artificial intelligence and augmented reality, are expected to further refine these techniques, enhancing their efficacy and accessibility. Future research should focus on large-scale, multicenter trials to provide more definitive comparisons and guide clinical decision-making.
随着腹腔镜和机器人技术的出现,微创肝脏手术,尤其是肝切除术,已经有了显著的发展。这些方法相对于传统开放手术具有潜在的优势,包括术后疼痛减轻、住院时间缩短、恢复更快以及美容效果改善。这篇综述旨在比较机器人肝切除术和腹腔镜肝切除术的手术效率和术后恢复结果。它试图深入分析每种技术的优缺点,评估其成本效益,并探索微创肝脏手术的新趋势和未来方向。通过全面的文献检索来确定比较机器人肝切除术和腹腔镜肝切除术的研究。该综述包括对手术时间、术中出血量、中转率、术后疼痛、住院时间、并发症发生率、肿瘤学结果和总体成本的分析。此外,还探讨了技术进步和未来研究方向,以全面概述这些手术技术的现状和未来潜力。机器人肝切除术和腹腔镜肝切除术在肿瘤学安全性和有效性方面都显示出相当的结果。然而,由于其先进的可视化和器械,机器人肝切除术在精准度和灵活性方面具有优势,特别是在复杂病例中。腹腔镜肝切除术虽然手术时间较短且成本较低,但受到技术挑战的限制,尤其是在主要肝脏切除术中。该综述还强调了尽管机器人系统成本较高且需要专门培训,但采用率仍在不断提高。机器人肝切除术和腹腔镜肝切除术都是微创肝脏手术的可行选择,各有其独特的优缺点。两者之间的选择应基于患者的具体因素、手术的复杂性和外科医生的专业知识。包括人工智能和增强现实集成在内的技术不断进步,有望进一步完善这些技术,提高其疗效和可及性。未来的研究应侧重于大规模、多中心试验,以提供更明确的比较并指导临床决策。