Updates in Surgery

, Volume 71, Issue 1, pp 39–48 | Cite as

Comparison between robotic and open liver resection: a systematic review and meta-analysis of short-term outcomes

  • Nikolaos MachairasEmail author
  • Dimetrios Papaconstantinou
  • Diamantis I. Tsilimigras
  • Dimitrios Moris
  • Anastasia Prodromidou
  • Anna Paspala
  • Eleftherios Spartalis
  • Ioannis D. Kostakis
Review Article


Minimally invasive liver surgery has evolved significantly during the last 2 decades. A growing number of published studies report outcomes from robotic liver resections (RLR). The aim of our meta-analysis was to evaluate short-term outcomes after RLR vs. open liver resection (OLR). A systematic search of Medline, Scopus, Google Scholar, Cochrane CENTRAL Register of Controlled Trials and databases for articles published from January 2000 until November 2018 was performed. Ten non-randomized retrospective clinical studies comprising a total of 1248 patients were included in our meta-analysis. Four hundred and fifty-eight patients underwent RLR and 790 underwent OLR. RLRs were associated with lower overall morbidity rates (p =0.006) and shorter hospital stay (p <0.00001), whereas OLRs were associated with shorter operative time (p =0.003). No differences were shown between the two groups with regard to blood loss, blood transfusion requirements, R0 resection and mortality rates. Cumulative conversion rate was 4.6% in the RLR group. Due to limited available data, further prospective randomized studies are needed to better determine the potential beneficial role of the robotic approach in the treatment of malignant and benign hepatic tumors.


Robotic Open liver resection Hepatectomy Morbidity Length of stay 


Compliance with ethical standards

Conflict of interest

The authors of this study declare no conflict of interest. The authors of this study declare no financial support.

Ethical approval

The article is in accordance with ethical standards.

Research involving human participants and/or animals

This study does not contain any study with human participants performed by any of the authors.

Informed consent



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Copyright information

© Italian Society of Surgery (SIC) 2019

Authors and Affiliations

  • Nikolaos Machairas
    • 1
    Email author
  • Dimetrios Papaconstantinou
    • 1
  • Diamantis I. Tsilimigras
    • 2
  • Dimitrios Moris
    • 2
    • 3
  • Anastasia Prodromidou
    • 2
  • Anna Paspala
    • 1
  • Eleftherios Spartalis
    • 2
  • Ioannis D. Kostakis
    • 4
  1. 1.3rd Department of Surgery, Attikon University Hospital, Medical SchoolNational and Kapodistrian University of AthensAthensGreece
  2. 2.Laboratory of Experimental Surgery and Surgical ResearchUniversity of Athens Medical SchoolAthensGreece
  3. 3.Department of SurgeryDuke University Medical CenterDurhamUSA
  4. 4.2nd Department of Propaedeutic Surgery, Laiko General Hospital, Medical SchoolNational and Kapodistrian University of AthensAthensGreece

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