Robotic hepatectomy for hepatocellular carcinoma: a clinical review

Abstract

How to cite this article: Lai ECH, Chung DTM, Chan OCY, Tang CN. Robotic hepatectomy for hepatocellular carcinoma: a clinical review. Hepatoma Res 2017;3:278-83.The robotic surgical system was developed to overcome the disadvantages of conventional laparoscopic surgery. The use of robots in liver surgery was not well evaluated. This article aimed at reviewing robotic partial hepatectomy to conventional laparoscopic or open partial hepatectomy in terms of perioperative, oncologic, and healthcare costs for hepatocellular carcinoma (HCC). Studies were identified by searching MEDLINE and PubMed databases for articles from January 2004 to June 2017 using the keywords "laparoscopic hepatectomy", "robotic surgery", "robotic hepatectomy", and "hepatocellular carcinoma". Case reports were not included. The open conversion rate, overall morbidity rate, and mortality rate of robotic partial hepatectomy were reported as 0-14.3%, 0-27%, and 0-3%, respectively. Although little data regarding robotic approach for HCC have been reported, it appears to be better than open approach, particularly blood loss and hospital stay, and similar to conventional laparoscopic approach in terms of short term outcomes. The oncological outcomes were comparable to open or laparoscopic approach. Well-known advantages of the robotic system allow resection of tumor location over posterior and superior segments or major hepatectomy with more ease. The main disadvantage of robotic approach was its high cost. In conclusion, oncological data from homogenous series of HCC after robotic partial hepatectomy was needed. Robotic approach was safe to be an alternative option of minimally invasive hepatectomy for HCC. Its future implementation will depend on the advantages that it can provide over open or conventional laparoscopy approach. Key words:Laparoscopy, hepatectomy, robotic surgery, hepatocellular carcinoma ABSTRACTArticle history:

Cost-Minimization Analysis of Robotic Versus LaparoscopicAssisted Liver Cancer Resection

“…Due to a number of technological advancements, including greater visibility, increased angulation and range of motion, and more precise suturing, robotic surgical systems are better than laparoscopic devices [20][21][22][23][24]. Robotic surgical systems are now employed in a wide range of operations and specialties, such as head and neck surgery, urology, endocrine surgery, metabolic and bariatric surgery, and all intra-abdominal surgery subspecialties [25][26][27].…”