Current status of robotic liver resection: a systematic review

Abstract

Robotic surgery is an emerging technique for the management of patients with liver disease, and only a limited number of reports are available. A systematic search of electronic databases (PubMed, Embase and Cochrane), including only case series with more than five patients, identified nine series (with one from our institution), which totaled to 232 patients. Overall, the peri-operative outcomes of the reported patients are similar to those utilizing the laparoscopic and open approaches. Robotic surgery appears to be a valid option for selected hepatic resections in experienced hands. It could represent a bridge toward minimally invasive approaches for confirmed liver surgeons. By contrast, the long-term oncological outcomes remain uncertain and need further studies.

Keywords::

• laparoscopy
• liver
• oncological
• resection
• robotic

Financial & competing interests disclosure

C Toso was supported by a Professorship from the Swiss National Science Foundation (PP00P3 139021). The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.

Key issues

• Robotic surgery appears to be a valid option for hepatic resection in experienced hands.

• It represents a good entry for open surgeons who want access into the minimally invasive world.

• The robotic platform allows the combining of the experience of hepatobiliary surgeons and robotic surgeons in the same procedures.

• The data currently available do not yet support the routine use of this technology and do not allow the best indications to be defined.

• On the other hand, the outcomes are promising and similar to laparoscopy and open approaches.

• While long-term oncological outcomes remain unclear and need further studies, the careful approach of experienced units appears promising and worth pursuing.