Comparison of laparotomy, laparoscopy, and da Vinci in Whipple, hepatectomy, pancreatectomy, and gastrectomy

Q: What surgeries and approaches are compared in this study?

The study compares four hepatopancreatobiliary surgeries—Whipple procedure, hepatectomy, pancreatectomy, and gastrectomy—across three approaches: open laparotomy, laparoscopic, and da Vinci robotic-assisted surgery.

Q: How many patients were included, and what was the study design?

A retrospective observational cohort study included 486 patients who underwent HPB surgery between July 2015 and September 2019, using a prospectively maintained institutional database.

Q: What outcomes showed significant differences among the approaches?

Significant differences were observed across procedures. Hospital stay and intraoperative bleeding were lower in laparoscopic and robotic groups for gastrectomy and improved in minimally invasive and robotic groups for hepatectomy, while operative time varied by procedure type.

Sep 29, 2026

Uploaded by jay

Cross-sectional retrospective observational cohort analysis evaluates whether advances in surgical imaging and technology improve outcomes across four major hepatopancreatobiliary procedures: the Whipple procedure, hepatectomy, pancreatectomy, and gastrectomy. Using a prospectively maintained university-affiliated database, 486 patients treated from July 2015 to September 2019 were compared among open laparotomy, laparoscopic, and da Vinci robotic-assisted approaches. Minimally invasive and robotic methods reduced hospital stay and intraoperative bleeding, while operative time varied by procedure and learning demand.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages9

Reading Time23 min

AccessFree to download

Introduction

Material and Methods

Results

Conclusions

Highlights

Cross-sectional Study Comparison of laparotomy, laparoscopy, and da Vinci in Whipple, hepatectomy, pancreatectomy, and gastrectomy Cheng-Ming Peng, MD, PhDa , Ming-Hung Lin, PhDb ,*, Chin-Tui Lin, EMBAc , Teng-Chieh Cheng, MSd , Ssu-Yu Yeh, MBAb Background: This study aimed to evaluate whether advances in surgical imaging and technology improve clinical outcomes, including operative time, hospital stay, and intraoperative bleeding, across four major hepatopancreatobiliary (HPB) surgeries: the Whipple procedure, hepatectomy, pancreatectomy, and gastrectomy, comparing open laparotomy, laparoscopic, and roboticassisted (da Vinci) approaches. Material and Methods: A retrospective observational cohort study was conducted using a prospectively maintained database from a university-affiliated minimally invasive surgery center. A total of 486 patients (269 males, 217 females; mean age 57.96 ± 15.71 years) who underwent HPB surgery between July 2015 and September 2019 were included. Surgical methodselection was determined by surgeon preference, patient condition, and the chronological introduction of the da Vinci system. One-way analysis of variance was used to compare operative time, hospital stay, and blood loss among the three methods in each surgical category. Results: Significant differences were observed among surgical approaches. In gastrectomy, hospital stay [F(2,158) = 18.66, P < 0.001] and bleeding [F(2,158) = 16.25, P < 0.001] were significantly lower in laparoscopic and robotic groups. In pancreatectomy, operative time [F(2,80) = 3.48, P = 0.04] and bleeding [F(2,80) = 3. 16, P = 0.05] showed significant variation, with longer duration in laparoscopy. In the Whipple procedure, only operative time differed [F(1,76) = 26.53, P < 0.001] . In hepatectomy, operative time [F(2,161) = 3.48, P = 0.03], hospital stay [F(2,161) = 11.53, P< 0.001], and bleeding [F(2,161) = 18.29, P < 0.001] were significantly improved in minimally invasive and robotic groups. Conclusions: Minimally invasive and robotic-assisted surgeries significantly reduced hospital stay and intraoperative bleeding compared with open laparotomy. Operative time varied across procedures, reflecting technical complexity and learning curves. These findings highlight the clinical benefits of image-guided and robotic-assisted techniques in complex abdominal surgery. Keywords: da Vinci Xi, gastrectomy robotic surgery, hepatectomy, pancreatectomy, Whipple Introduction During open surgery, also called laparotomy, after anesthetizing patients, surgeons make a single large incision over the affected aDepartment of Surgery, da Vinci Minimally Invasive Surgery Center, Chung Shan Medical University Hospital, Taichung City, Taiwan, bGraduate Institute of Sports and Health Management, National Chung Hsing University, Taichung City, Taiwan, cCollege of Management, National Chung Hsing University, Taichung City, Taiwan and dDepartment of Medical Technology, Chung Shan Medical University, Taichung City, Taiwan Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article. *Corresponding author. Address: Graduate Institute of Sports and Health Management, National Chung Hsing University, 145 Xingda Rd., South Dist., Taichung City 402, Taiwan. Tel.: 886-4-22840845\#702; Fax: 886-4-22852400. E-mail: [linraymh@email.nchu.edu.tw](linraymh@email.nchu.edu.tw) (M.-H. Lin). Copyright © 2025 The Author(s). Published by Wolters Kluwer Health, Inc. This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. Annals of Medicine & Surgery (2026) 88:211–219 Received 21 July 2025; Accepted 19 November 2025 Published online 5 December 2025 [http://dx.do

FAQs

What surgeries and approaches are compared in this study?

The study compares four hepatopancreatobiliary surgeries—Whipple procedure, hepatectomy, pancreatectomy, and gastrectomy—across three approaches: open laparotomy, laparoscopic, and da Vinci robotic-assisted surgery.

How many patients were included, and what was the study design?

A retrospective observational cohort study included 486 patients who underwent HPB surgery between July 2015 and September 2019, using a prospectively maintained institutional database.

What outcomes showed significant differences among the approaches?

Significant differences were observed across procedures. Hospital stay and intraoperative bleeding were lower in laparoscopic and robotic groups for gastrectomy and improved in minimally invasive and robotic groups for hepatectomy, while operative time varied by procedure type.

Sep 29, 2026

Uploaded by jay