Robotic resection in liver malignancies

Abstract

Minimally invasive surgery in liver malignancies has always been a challenge to surgeons. Although laparoscopic liver resection had been proved feasible and safe, the steep learning curve indicates the difficulties itself. Robotic system arises to tackle the limitations of laparoscopic surgery with its unique features. Literature review of robotic liver resection in recent years on MEDLINE and PubMed was explored. The outcomes of surgical parameters, learning curve and feasibility were concluded in this review along with pros and cons of robotic liver resection. There are no significant differences in short-term perioperative outcomes regarding blood loss, morbidity and mortality rates and hospital stay. The longterm outcomes of robotic liver resection have not been well analyzed. Robotic group had a significant higher proportion of major hepatectomies and resection of tumors located at posterosuperior segments compared with laparoscopic group. Robotic liver resection is considered as feasible and safe in experienced hands. Its featured instrument advantages allow surgeon to tackle problems encountered in laparoscopic procedures and to advance to other disease entities. A dedicated team proficient in equipment, surgical expertise and well-established proctorship are key factors in implementation of clinical use. Large scale multicenter randomized control trials are still mandated to draw definite conclusions.