A new study suggests that robotic liver surgery can be a safe outpatient procedure.
Eight per cent of the patients sampled in the analysis were discharged to go home on the same day.
The research, published in the Journal of the American College of Surgeons, is guided by a surgeon at City of Hope, one of the US’s largest cancer research and treatment organisations.
Yuman Fong, senior author of the study, Sangiacomo Family Chair in Surgical Oncology at City of Hope and director of City of Hope’s Centre for Surgical Innovation said: ‘This study is proof that for the right patients and with the right tools – meaning robotic surgery – we can get people through a liver operation quicker and toward recovery and normal life faster.’
Researchers evaluated patient data (n=4,408) between 2013 and 2023 from three American cancer centres, including the City of Hope, and three Dutch centres. They identified 307 patients who had received robotic liver surgery as outpatients, which was defined as a procedure requiring less than two nights of hospital stay.
While some patients had liver or biliary cancer in a single organ, most patients (n=150) had colorectal cancer that had spread to the liver.
Other diagnoses included cancers of the neuroendocrine system, breast and lung that had spread to the liver.
The medical community has been debating whether liver surgery can and should be a robotic procedure because liver surgery is complex.
Bleeding or other surgical complications often arise, requiring admission into the intensive care unit.
Fong said: ‘Not long ago, liver resections were considered an open surgery procedure that requires a fairly big incision. Patients often need to stay in the hospital for five to 14 days, and they're usually admitted to intensive care units. Even after leaving the hospital, recovery from such surgeries will often take three to six weeks. In this study of robotic surgery, we found that by one week, many of these patients could take 5,000 to 6,000 steps.’
Fong added that the readmission rate of open liver surgery is 20-25% at most prominent cancer centres. Yet, in this retrospective analysis of data from six centres in two nations, the readmission rate for robotic hepatectomy was 1.6%.
Photo caption - Dr Yuman Fong. Credit: CITY OF HOPE
