• Adrian K H Chiow, David Fuks, Gi-Hong Choi, Nicholas Syn, Iswanto Sucandy, Marco V Marino, Mikel Prieto, Charing C Chong, Jae Hoon Lee, Mikhail Efanov, T Peter Kingham, Sung Hoon Choi, Robert P Sutcliffe, Roberto I Troisi, Johann Pratschke, Tan-To Cheung, Xiaoying Wang, Rong Liu, Mathieu D'Hondt, Chung-Yip Chan, Chung Ngai Tang, Ho-Seong Han, GohBrian K PBKP0000-0001-8218-4576Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital and Duke-National University Singapore Medical School, Singapore., and International Robotic and Laparoscopic Liver Resection Study Group collaborators.
• Hepatopancreatobiliary Unit, Department of Surgery, Changi General Hospital, Singapore.
• Br J Surg. 2021 Dec 1; 108 (12): 151315201513-1520.

BackgroundMinimally invasive right posterior sectionectomy (RPS) is a technically challenging procedure. This study was designed to determine outcomes following robotic RPS (R-RPS) and laparoscopic RPS (L-RPS).MethodsAn international multicentre retrospective analysis of patients undergoing R-RPS versus those who had purely L-RPS at 21 centres from 2010 to 2019 was performed. Patient demographics, perioperative parameters, and postoperative outcomes were analysed retrospectively from a central database. Propensity score matching (PSM) was performed, with analysis of 1 : 2 and 1 : 1 matched cohorts.ResultsThree-hundred and forty patients, including 96 who underwent R-RPS and 244 who had L-RPS, met the study criteria and were included. The median operating time was 295 minutes and there were 25 (7.4 per cent) open conversions. Ninety-seven (28.5 per cent) patients had cirrhosis and 56 (16.5 per cent) patients required blood transfusion. Overall postoperative morbidity rate was 22.1 per cent and major morbidity rate was 6.8 per cent. The median postoperative stay was 6 days. After 1 : 1 matching of 88 R-RPS and L-RPS patients, median (i.q.r.) blood loss (200 (100-400) versus 450 (200-900) ml, respectively; P < 0.001), major blood loss (> 500 ml; P = 0.001), need for intraoperative blood transfusion (10.2 versus 23.9 per cent, respectively; P = 0.014), and open conversion rate (2.3 versus 11.4 per cent, respectively; P = 0.016) were lower in the R-RPS group. Similar results were found in the 1 : 2 matched groups (66 R-RPS versus 132 L-RPS patients).ConclusionR-RPS and L-RPS can be performed in expert centres with good outcomes in well selected patients. R-RPS was associated with reduced blood loss and lower open conversion rates than L-RPS.© The Author(s) 2021. Published by Oxford University Press on behalf of BJS Society Ltd. All rights reserved. For permissions, please email: journals.permissions@oup.com.

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