Robotic-assisted Distal Pancreatectomy Is Associated With Significant Reduction of Morphine Consumption for the Treatment of Acute Postoperative Pain

Background/Aim: Minimal-invasive techniques have been increasingly performed to treat pancreatic lesions. We evaluated the differences between open and robotic approach for distal pancreatectomy (DP) in terms of postoperative analgesic consumption and perioperative outcomes.

Patients and Methods: Clinicopathological data of patients undergoing DP from 2012-2023 were evaluated. The study compared robotic (RDP) with open distal pancreatectomies (ODP) regarding total postoperative morphine consumption. Secondary endpoints included intensive care unit (ICU) stay and hospital stay.

Results: During the study period, 78 DP were performed, including, 24 RDP and 54 ODP. Multivisceral resections including DP and laparoscopic DP were excluded. Patients who underwent RDP required significantly less opioid analgesics compared to those after ODP (113.60 mg; 0,00-516,20 mg morphine milligram equivalents; median; minimum-maximum vs. 253.75 mg; 15,00-3519,45 mg; p<0.001). When adjusted for patient weight, the morphine equivalent dose also showed a significant difference between RDP and ODP (1.51; 0,00-6,53 mg/kg vs. 3.19; 0,24-62,85 mg/kg; p=0.004). Additionally, patients who underwent RDP had significantly shorter postoperative ICU stay compared to patients with ODP (0; 0-7 days vs. 4; 1-54 days; p<0.001) and shorter hospital stay compared to the open group (10.5; 6-33 days vs. 16; 9-92 days; p<0.001).

Conclusion: Patients who underwent RDP required significantly lower amounts of opioid analgesics compared to ODP. Furthermore, RDP was associated with significantly shorter length of ICU and hospital stay.