Acute postoperative pain management after living donor hepatectomy during the transition from an open to minimally invasive surgical approach

Background: Acute post-surgical pain is a common concern for patients undergoing living donor hepatectomy (LDH), potentially leading to unfavorable outcomes if not treated adequately. This study aimed to evaluate the impact of the transition of surgical techniques from open and laparoscopic to robot...

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Main Authors: Amer Majeed, Noon E. Abdelgadir, Areej A. G. AlFattani, Muhammad Hafeez, Muhammad A. Jahangir, Mohamad S. Nagy
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2025-01-01
Series:Saudi Journal of Anaesthesia
Subjects:
Online Access:https://journals.lww.com/10.4103/sja.sja_415_24
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author Amer Majeed
Noon E. Abdelgadir
Areej A. G. AlFattani
Muhammad Hafeez
Muhammad A. Jahangir
Mohamad S. Nagy
author_facet Amer Majeed
Noon E. Abdelgadir
Areej A. G. AlFattani
Muhammad Hafeez
Muhammad A. Jahangir
Mohamad S. Nagy
author_sort Amer Majeed
collection DOAJ
description Background: Acute post-surgical pain is a common concern for patients undergoing living donor hepatectomy (LDH), potentially leading to unfavorable outcomes if not treated adequately. This study aimed to evaluate the impact of the transition of surgical techniques from open and laparoscopic to robot-assisted minimally invasive surgical (MIS) approach, and the different types of graft resection, including right, left, and left lateral partial lobectomy (LL), on analgesia requirements during the first two postoperative days. Methods: A single-center retrospective electronic chart review of all patients who underwent LDH procedures between 2018 and 2020 was performed. Results: Patients underwent LDH procedure (n = 414) through open (n = 93, 22%), laparoscopic (n = 68, 16%), or robot-assisted MIS (n = 253, 61%) approaches; and had right lobectomy (n = 215, 52%), left lobectomy (n = 121, 29%), or LL (n = 78, 19%). Postoperatively within the first 48 h, the pain reported on a 3-point Visual Analogue Scale (VAS), was mild 77%, moderate 21%, or severe only 2%. The laparoscopic approach and LL resection were associated with higher pain scores, whereas the robotic approach was the least painful overall. Conclusions: Robot-assisted MIS approach for LDH procedure resulted in lower acute pain scores when compared with other surgical approaches, obviating the need for intravenous (IV) patient-controlled analgesia (PCA).
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spelling doaj-art-968923d1301d4edd992514fba435a3202025-02-06T07:24:16ZengWolters Kluwer Medknow PublicationsSaudi Journal of Anaesthesia1658-354X0975-31252025-01-01191142010.4103/sja.sja_415_24Acute postoperative pain management after living donor hepatectomy during the transition from an open to minimally invasive surgical approachAmer MajeedNoon E. AbdelgadirAreej A. G. AlFattaniMuhammad HafeezMuhammad A. JahangirMohamad S. NagyBackground: Acute post-surgical pain is a common concern for patients undergoing living donor hepatectomy (LDH), potentially leading to unfavorable outcomes if not treated adequately. This study aimed to evaluate the impact of the transition of surgical techniques from open and laparoscopic to robot-assisted minimally invasive surgical (MIS) approach, and the different types of graft resection, including right, left, and left lateral partial lobectomy (LL), on analgesia requirements during the first two postoperative days. Methods: A single-center retrospective electronic chart review of all patients who underwent LDH procedures between 2018 and 2020 was performed. Results: Patients underwent LDH procedure (n = 414) through open (n = 93, 22%), laparoscopic (n = 68, 16%), or robot-assisted MIS (n = 253, 61%) approaches; and had right lobectomy (n = 215, 52%), left lobectomy (n = 121, 29%), or LL (n = 78, 19%). Postoperatively within the first 48 h, the pain reported on a 3-point Visual Analogue Scale (VAS), was mild 77%, moderate 21%, or severe only 2%. The laparoscopic approach and LL resection were associated with higher pain scores, whereas the robotic approach was the least painful overall. Conclusions: Robot-assisted MIS approach for LDH procedure resulted in lower acute pain scores when compared with other surgical approaches, obviating the need for intravenous (IV) patient-controlled analgesia (PCA).https://journals.lww.com/10.4103/sja.sja_415_24laparoscopyliving donor hepatectomypatient-controlled analgesiapostoperative painrobotic surgical procedures
spellingShingle Amer Majeed
Noon E. Abdelgadir
Areej A. G. AlFattani
Muhammad Hafeez
Muhammad A. Jahangir
Mohamad S. Nagy
Acute postoperative pain management after living donor hepatectomy during the transition from an open to minimally invasive surgical approach
Saudi Journal of Anaesthesia
laparoscopy
living donor hepatectomy
patient-controlled analgesia
postoperative pain
robotic surgical procedures
title Acute postoperative pain management after living donor hepatectomy during the transition from an open to minimally invasive surgical approach
title_full Acute postoperative pain management after living donor hepatectomy during the transition from an open to minimally invasive surgical approach
title_fullStr Acute postoperative pain management after living donor hepatectomy during the transition from an open to minimally invasive surgical approach
title_full_unstemmed Acute postoperative pain management after living donor hepatectomy during the transition from an open to minimally invasive surgical approach
title_short Acute postoperative pain management after living donor hepatectomy during the transition from an open to minimally invasive surgical approach
title_sort acute postoperative pain management after living donor hepatectomy during the transition from an open to minimally invasive surgical approach
topic laparoscopy
living donor hepatectomy
patient-controlled analgesia
postoperative pain
robotic surgical procedures
url https://journals.lww.com/10.4103/sja.sja_415_24
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AT areejagalfattani acutepostoperativepainmanagementafterlivingdonorhepatectomyduringthetransitionfromanopentominimallyinvasivesurgicalapproach
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