چکیده (انگلیسی):

Background: Minimally invasive liver resection is feasible for select patients. The
flexibility of robotic surgical instruments improves the possibility of minimally invasive liver
resection, even in challenging major liver resection.
Materials and methods: We accumulated 69 patients who underwent pure laparoscopic liver
resection from 2007 to 2011, and 52 patients who underwent robotic-assisted minimally invasive
liver resection in 2012. The patients’ characteristics, surgical procedures, and perioperative
parameters were described and compared between these two groups.
Results: In 2012, we performed 56 robotic hepatobiliary procedures, which included 52 (92%)
robotic-assisted minimally invasive liver resection procedures. Under the assistance of a robotic
system, we increased the number of patients undergoing minimally invasive liver resection
by more than twofold, and we increased the percentage of minimally invasive surgery for
patients with fresh hepatocellular carcinoma, compared to our laparoscopic group (44% vs.
15%, respectively). We also increased the percentage of major hepatectomy for minimally
invasive liver resection by a robotic approach (39% vs. 15%) with a comparable conversion rate
(5%) and morbidity (8%), compared to the laparoscopic group. We can even perform a challenging
living donor liver harvest procedure with a robotic-assisted minimally invasive
approach.
Conclusion: Robotic assistance increased the percentage of minimally invasive liver resections
and the percentage of major minimally invasive liver resections with comparable perioperative
results. Robotic-assisted minimally invasive liver resection is feasible, but its role needs more
accumulated experience to clarify.