Comparative Analysis of Robotic Versus Laparoscopic Approaches in Minimally Invasive Spleen and Splenic Vessel Preserving Distal Pancreatectomy

摘要

BACKGROUND: The use of robotic surgery in minimally invasive spleen and splenic vessel preserving distal pancreatectomy, known as Kimura technique (MI-KT), is on the rise. This study aims to compare the surgical outcomes of robotic and laparoscopic approaches. METHODS: We performed a retrospective analysis of patients who underwent MI-KT at the National Cheng Kung University Hospital, comparing outcomes such as spleen preservation rate, operation time, blood loss, complications, and length of hospital stay, using propensity score matching. RESULTS: Among 136 patients (111 laparoscopic, 25 robotic), proficiency milestones differed significantly. Although no statistically significant differences were observed in postoperative outcomes between the robotic and laparoscopic groups post-matching, the robotic approach exhibited a shorter learning curve (p < 0.001). Tumor size (OR 1.5, p = 0.015) was identified crucial to completion of KT. CONCLUSIONS: This study suggests that while the robotic approach may be advantageous in terms of learning curve, postoperative outcomes such as spleen preservation rates and hospital length of stay are comparable between the two methods, emphasizing the need for further analysis of patient selection and surgical techniques.