Robotic liver resection for malignancy: Current status, oncologic outcomes, comparison to laparoscopy, and future applications

Abstract

Utilization of robotic techniques for resection of the liver is slowly gaining acceptance in specific situations and is now being applied to more challenging endeavors, such as major hepatectomy for cancer. This review provides a summary of robotic applications in liver surgery, with specific attention perioperative outcomes, oncologic outcomes, cost, and comparison to conventional laparoscopic techniques of liver resection. We also discuss future applications of robotic-assisted liver surgery.

Robotic liver surgery: technical aspects and review of the literature

“…One of the limits of robotic HPB surgery is the need for specialized training, not only for the primary surgeon, but also for the assistant surgeon and OR nurses, although in some cases, the learning curve for specific robotic procedures has proven to be shorter than the laparoscopic equivalent (17). Moreover, hepatobiliary surgeons, at the beginning of their robotic learning curve, might have a limited number of simple cases that could be used as a training model.…”

“…Oncologic laparoscopic liver resections have also proven to be feasible and safe when performed in expert hands, with oncologic outcomes that are equivalent to traditional open surgery in terms of margin infiltration and local recurrence (1,2,5,10,(12)(13)(14)(15)(16)(17). In liver surgery, laparoscopy presents some peculiar advantages as the preservation of the abdominal wall from large subcostal incisions.…”

Estimation of External Forces on the Basis of Local Displacement Observations of an Elastic Body

“…If f is successfully reconstructed, the displacement of the unobservable vertices u i can be calculated by substituting f into equation (1). Therefore, it is also possible to estimate the displacement of all the vertices using only the local displacement in a mesh model.…”

“…Using this method to improve visibility for endoscopic surgeons is an important advancement because, unlike open surgery, endoscopic surgery involves operating with forceps or radio knives while observing the inside of the patient s body through an endoscope. Many attempts to improve the conditions for delicate endoscopic surgery have been undertaken, including robotic-assisted surgery systems [1].…”

Anesthesia in Liver Resections: Review

“…Laparoscopic and robotic techniques have also been adopted for liver resection, avoiding large incisions, bleeding and low tenor of postoperative pain [39].…”