Laparoscopic robot-assisted major hepatectomy

Background We herein present a systematic review of English literature on robot-assisted major hepatectomy (MH). Methods Major hepatectomy was defined as resection of three or more liver segments. A literature search was performed using the Pubmed database. Articles containing more than five robotic MH were selected. In case of multiple publications from the same institution, only the most recent article was considered in order to avoid double counting of patients between series. Results Five articles were included in this review. A total of 68 robotic MH were analyzed, including 38 right hepatectomies and 30 left hepatectomies. There were no deaths. Two right hepatectomies (5.2%) and one left hepatectomy (3.3%) were converted to open surgery. Weighted average of operative time and intraoperative blood loss were 418.6 min and 411.4 ml, respectively. Four patients received blood transfusions (6.3%) and 17 developed postoperative complications (26.9%). Information on tumor type were available for 57 patients of whom 42 were diagnosed with malignant tumors (73.6%) and 15 with benign diseases (26.3%). No port site metastasis, peritoneal carcinomastosis, or intrahepatic recurrence were reported. Three patients had microscopic margin positivity. Conclusions Major hepatectomy can be performed under robotic assistance. Further experience is needed before final conclusions can be drawn.