Robotic liver resection: Hurdles and beyond

Int J Surg. 2020 Oct:82S:155-162. doi: 10.1016/j.ijsu.2020.05.070. Epub 2020 Jun 3.

Abstract

Laparoscopy is currently considered the standard of care for certain procedures such as left-lateral sectionectomies and wedge resections of anterior segments. The role of robotic liver surgery is still under debate, especially with regards to oncological outcomes. The purpose of this review is to describe how the field of robotic liver surgery has expanded, and to identify current limitations and future perspectives of the technology. Available evidences suggest that oncologic results after robotic liver resection are comparable to open and laparoscopic approaches for hepatocellular carcinoma and colorectal liver metastases, with identifiable advantages for cirrhotic patients and patients undergoing repeat resections. Excellent outcomes and optimal patient safety can be only achieved with specific hepato-biliary and general minimally invasive training to overcome the learning curve.

Keywords: CRLM; Cholangiocarcinoma; Cirrhosis; HCC; ICG; LDLT; Learning curve.

Publication types

  • Editorial
  • Review

MeSH terms

  • Carcinoma, Hepatocellular / economics
  • Carcinoma, Hepatocellular / surgery*
  • Hepatectomy / economics
  • Hepatectomy / methods*
  • Humans
  • Laparoscopy / economics
  • Laparoscopy / methods
  • Learning Curve
  • Liver / surgery*
  • Liver Neoplasms / economics
  • Liver Neoplasms / secondary
  • Liver Neoplasms / surgery*
  • Liver Transplantation / economics
  • Liver Transplantation / methods
  • Living Donors
  • Robotic Surgical Procedures / methods*
  • Tissue and Organ Harvesting / economics
  • Tissue and Organ Harvesting / methods