Robot-assisted surgery: improved tool for major liver resections?

Minimally invasive liver surgery has recently undergone an explosion in reported worldwide experience. Given its comparable outcomes to its open counterpart, high-volume centers are utilizing minimal access liver surgery more frequently under well-defined criteria. The recent introduction of robot-assisted surgery has further revolutionized the field of minimally invasive surgery and has expanded the reach of feasibility. Robot-assisted surgery was developed to help overcome the disadvantages of conventional laparoscopic surgery. As a result, there has been an increase in the reporting of advanced robot-assisted liver resections. A literature review was performed to identify the current manuscripts describing robot-assisted liver surgery. Nine case series were identified, yielding 144 unique patient characteristics. Outcomes indicate that robot-assisted liver resection is feasible and safe for both minor and major liver resections with regard to estimated blood loss, length of stay, and complications. Early data also suggest that robot-assisted liver surgery is efficacious with regard to short-term oncologic outcomes. Future studies will be needed to better evaluate advantages and disadvantages compared to laparoscopic liver resections.