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Journal of Robotic Surgery

, Volume 13, Issue 4, pp 533–538 | Cite as

Robotic hepatic surgery in malignancy: review of the current literature

  • René FahrnerEmail author
  • Falk Rauchfuß
  • Astrid Bauschke
  • Hermann Kissler
  • Utz Settmacher
  • Jürgen Zanow
Review Article

Abstract

The use of minimally invasive liver surgery, such as laparoscopic and robotic surgery, is increasing worldwide. Robot-assisted laparoscopy is a new surgical technique that improves surgical handling. The advantage of this technique is improved dexterity, which leads to increased surgical precision and no tremor or fatigue. Comparable oncological results were documented for laparoscopic and open surgery. Currently, “conventional” laparoscopic liver surgery has limitations with respect to the treatment of lesions in the posterior-superior segments, and there are limited technical features for the reconstruction steps. These limitations might be overcome with the use of robotic surgery. The use of robotic surgery for hepatic procedures originated because of the technical potential to overcome several of the major technical limitations known from conventional laparoscopy and the possibility of performing more extended liver resections. Additionally, there is increasing evidence indicating that robotic hepatic surgery is feasible and safe in resections of the posterior segments. Studies showed that using the robotic technique is associated with a decreased or at least equal amount of intraoperative blood loss compared to that of the conventional laparoscopic or open technique. There is increasing evidence that robotic liver surgery might be as safe as conventional laparoscopic procedures in cancer cases in terms of resection margins, disease-free and overall survival. Furthermore, robotic surgery might be more favorable with respect to postoperative patient recovery. Despite promising results, still large, multicenter, randomized and prospective studies are needed to analyze the exact value of robotic liver surgery in patients with malignant liver tumors.

Keywords

Robotic surgery Liver surgery Malignancy Learning curve Surgical technique 

Notes

Compliance with ethical standards

Conflict of interest

R. Fahrner received travel support of Biotest, F. Rauchfuss received lecture fees and travel support of Astellas, Novartis, Roche and Biotest, A. Bauschke, H. Kissler, U. Settmacher and J. Zanow have no conflict of interests.

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Copyright information

© Springer-Verlag London Ltd., part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of General, Visceral and Vascular SurgeryJena University HospitalJenaGermany

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