Robotic Surgery for Malignant Liver Disease: a Systematic Review of Oncological and Surgical Outcomes

  • Rafael Diaz-NietoEmail author
  • Soumil Vyas
  • Dinesh Sharma
  • Hassan Malik
  • Stephen Fenwick
  • Graeme Poston
Review Article


Robot-assisted laparoscopic surgery is yet another modification of minimally invasive liver surgery. It is described as feasible and safe from the surgical point of view; however, oncological outcomes need to be adequately analysed to justify the use of this technique when resecting malignant liver tumours. We reviewed existing English medical literature on robot-assisted laparoscopic liver surgery. We analysed surgical outcomes and oncological outcomes. We analysed operative parameters including operative time, type of hepatectomy, blood loss, conversion rate, morbidity and mortality rates and length of stay. We also analysed oncological outcomes including completeness of resection (R status), recurrence, survival and follow-up data. A total of 582 patients undergoing robot-assisted laparoscopic liver surgery were analysed from 17 eligible publications. Only 5 publications reported survival data. The overall morbidity was 19% with 0.2% reported mortality. R0 resection was achieved in 96% of patients. Robotic liver surgery is feasible and safe with acceptable morbidity and oncological outcomes including resection margins. However, well-designed trials are required to provide evidence in terms of survival and disease-free intervals when performed for malignancy.


Liver resection Robotic surgery Hepatectomy Laparoscopy 


Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.


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Copyright information

© Indian Association of Surgical Oncology 2019

Authors and Affiliations

  • Rafael Diaz-Nieto
    • 1
    Email author
  • Soumil Vyas
    • 2
  • Dinesh Sharma
    • 3
  • Hassan Malik
    • 1
  • Stephen Fenwick
    • 1
  • Graeme Poston
    • 1
  1. 1.Hepatobiliary Surgery UnitAintree University HospitalLiverpoolUK
  2. 2.Division of HPB surgerySurgical Gastroenterology and Surgical Oncology Sir H N Reliance Foundation HospitalMumbaiIndia
  3. 3.HPB/Liver Transplant Surgery UnitRoyal Free HospitalLondonUK

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