Comparison Of Robotic Hepatectomy And Traditional Laparoscopic Liver Resection

Objective: In the 21 st century,with the development of digital medicine and intelligent medical equipment,hepatobiliary surgery has gradually entered the era of precision medicine characterized by digitalization and micro-invasiveness.Robotic surgical systems have received much attention due to their precision and minimally invasive features.In the field of liver surgery,due to the complex anatomy of the liver and biliary tract,the unique value of the robotic surgical system is reflected.This article aims to explore robotic liver resection(RLR)and laparoscopic liver resection.Methods: Retrospective analysis of 35 cases of partial hemisection of the Da Vinci robotic surgery system performed by the Union Hospital of Fujian Medical University from December 2016 to January 2019.The operation duration,intraoperative blood loss,and conversion to open surgery were counted.Clinical data such as rate and postoperative complication rate,R0 resection rate,and clinical data of 82 cases of conventional laparoscopic liver resection were compared.Results: There were no deaths in the two groups of patients,and they were successfully discharged after discharge.Among them,3 patients in the robot group had more than1000 ml of bleeding,and 4 in the laparoscopic group.The duration of operation was robot group(176.11±98.54)and laparoscopic group(144.09±66.38)(P=0.042).The doses were robotic hepatectomy group(50 ml)and laparoscopic liver resection group(100 ml)(P=0.047).The conversion to open surgery rates were robotic hepatectomy group(2.9%)and laparoscopic liver resection group(7.3%)(P=0.0.036);the remaining data were the tumor size of the robot group(3.74±2.04)and the laparoscopic liver resection group(3.97±1.92)(P=0.572).The probability of intraoperative blood transfusion was The robot group(11.4%)and the laparoscopic group(6.1%)(P=0.322),the postoperative hospital stay were robot group(8.63±5.05)and laparoscopic group(8.45±3.12)(P=0.391),total hospitalization.The costs were robot group(71264.65±17388.38)and laparoscopic group(42590.30±20353.85)(P<0.0001).The R0 resection rate of malignant tumors in both groups was 100%.It can be seen that the operation time of the robot group is slightly longer than that of the laparoscopic group,but compared with the laparoscopic group,the robotic surgery reduces the amount of intraoperative blood loss and reduces the rate of conversion to open surgery.Conclusion: Compared with traditional laparoscopic liver resection,robotic hepatectomy can prolong the operation time of patients to a certain extent,but it can effectively reduce the amount of intraoperative blood loss and reduce the rate of conversion to open surgery.Therefore,its value in clinical applications is worthy of recognition.However,the high surgical cost of the robot and the high requirements on the equipment and the operator are important factors that hinder the wide development of this technology.If the equipment and technology can be further improved and upgraded,and the hospitalization cost can be reduced,the robot assisted hepatectomy in the liver surgery The advantages in the field of surgery will be more obvious.