Schmelzle Moritz, Krenzien Felix, Schöning Wenzel, Pratschke Johann
Chirurgische Klinik, Campus Charité Mitte | Campus Virchow-Klinikum, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Deutschland.
Chirurg. 2021 Feb;92(2):107-114. doi: 10.1007/s00104-020-01300-w.
Minimally invasive liver surgery is now the standard procedure at experienced centers, whereby the techniques and strategies are continuously evolving.
An analysis of English language literature on minimally invasive and robotic liver surgery was performed. The current scientific status was summarized and evaluated on the basis of experience at our own center.
The advantages of the minimally invasive technique compared to the conventional open technique are shown in liver surgery by improved perioperative results. Concerns about intraoperative complications and possible compromises in oncological radicality have been addressed in a number of publications. First reports on the robot-assisted technique seem to confirm the known advantages of laparoscopic liver surgery. The data available on robot-assisted liver surgery are still limited due to the short period of experience of a few centers and do not yet allow final conclusions; however, an increase in intraoperative safety and an expansion of the surgical spectrum towards highly complex liver resections seems likely.
Even during the learning curve the known advantages of laparoscopic liver surgery seem to be confirmed also for robot-assisted liver surgery. According to the center's own experience, minimally invasive liver surgery will in future be meaningfully supplemented by robotic technology. In particular, technically highly complex resections with reconstruction are made possible.
微创肝脏手术目前是经验丰富的医疗中心的标准术式，其技术和策略也在不断发展。
对英文的微创及机器人辅助肝脏手术相关文献进行分析。基于我们自己中心的经验总结并评估当前的科学现状。
与传统开放手术相比，微创技术在肝脏手术中的优势体现在围手术期结果得到改善。许多出版物都讨论了对术中并发症以及肿瘤根治性可能受到影响的担忧。关于机器人辅助技术的首批报告似乎证实了腹腔镜肝脏手术的已知优势。由于少数中心的经验积累时间较短，机器人辅助肝脏手术的现有数据仍然有限，尚无法得出最终结论；然而，术中安全性的提高以及手术范围向高度复杂肝脏切除术的扩展似乎是有可能的。
即使在学习曲线阶段，腹腔镜肝脏手术的已知优势似乎也适用于机器人辅助肝脏手术。根据该中心自身经验，未来机器人技术将对微创肝脏手术起到有意义的补充作用。特别是，技术上高度复杂的带重建的肝脏切除术将成为可能。
