Safety and effectiveness of the da Vinci robot with the "3+2" mode for distal pancreatectomy

Cancer Med. 2019 Aug;8(9):4226-4234. doi: 10.1002/cam4.2353. Epub 2019 Jun 18.

Abstract

Background: Recently, no relevant research has focused on the relationship between the clinical efficacy of da Vinci robotic distal pancreatectomy (RDP) and the number of mechanical arms and assistants used for RDP. The aim of this study was to evaluate the safety, efficacy, and advantages of RDP with the "3 + 2" mode.

Methods: Clinical data from 53 patients (observation group) who received RDP using the "3 + 2" mode in our department, from March 2016 to September 2018, were reviewed. An additional 53 patients who received RDP using the classical mode were chosen at random for the control group. Short-term outcomes for the two groups were compared.

Results: There were no statistically significant differences between the two groups for estimated blood loss, postoperative day of flatus passage, postoperative hospital stay, and postoperative complication (P > 0.05). Compared with the control group, the observation group had a significantly shorter operative time (166.9 ± 13.3 vs 192.6 ± 11.1 minutes, P < 0.001), lower surgical costs ($2827.79 ± $173.02 vs $3900.63 ± $317.29, P < 0.001).

Conclusions: The RDP using the "3 + 2" mode can increase the exposure of surgical field, improve cooperation between assistants, lower the surgical costs, and shorten the operative time and learning curve. Moreover, the clinical effect is equal to that of RDP using the classical mode. These findings indicate that RDP using the "3 + 2" mode is safe and feasible for institutions that are equipped for robot-assisted surgery.

Keywords: distal pancreatectomy; pancreatic neoplasm; robotic surgical; “3+2” mode.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Case-Control Studies
  • Humans
  • Length of Stay
  • Middle Aged
  • Operative Time
  • Pancreatectomy / adverse effects
  • Pancreatectomy / economics
  • Pancreatectomy / instrumentation*
  • Pancreatic Neoplasms / economics
  • Pancreatic Neoplasms / surgery*
  • Postoperative Complications
  • Robotic Surgical Procedures / adverse effects
  • Robotic Surgical Procedures / economics
  • Robotic Surgical Procedures / methods*
  • Survival Analysis
  • Treatment Outcome