Department of General, Visceral and Transplant Surgery, University Hospital Münster, Germany.
Z Gastroenterol. 2021 Jan;59(1):56-62. doi: 10.1055/a-1329-3067. Epub 2021 Jan 11.
Robotic liver surgery is emerging as the future of minimal invasive surgery. The robotic surgical system offers a stable camera platform, elimination of physiologic tremor, augmented surgical dexterity as well as improved ergonomics because of a seated operating position. Due to the theoretical advantages of the robotic assisted system, complex liver surgery might be an especially interesting indication for a robotic approach since it demands delicate tissue dissection, precise intracorporeal suturing as well as difficult parenchymal transection with subsequent need for meticulous hemostasis and biliostasis.
An analysis of English and German literature on open, laparoscopic and robotic liver surgery was performed and this review provides a general overview of the existing literature along with current standards and aims to specifically point out future directions of robotic liver surgery.
Robotic liver surgery is safe and feasible compared to open and laparoscopic surgery, with improved short-term postoperative outcomes and at least non-inferior oncological outcomes.
In complex cases including major hepatectomies, extended hepatectomies with biliary reconstruction and difficult segmentectomies of the posterior-superior segments, robotic surgery appears to emerge as a reasonable alternative to open surgery rather than being an alternative to laparoscopic procedures.
机器人肝手术作为微创外科的未来正在兴起。机器人手术系统提供了一个稳定的摄像平台，消除了生理震颤，增强了手术的灵巧性，并由于采用了坐姿操作，改善了人体工程学。由于机器人辅助系统的理论优势，复杂的肝脏手术可能是机器人手术的一个特别有趣的适应证，因为它需要精细的组织解剖、精确的腔内缝合以及困难的实质切开，随后需要精细的止血和胆汁淤积。
对开放、腹腔镜和机器人肝手术的英文和德文文献进行了分析，本综述提供了现有文献的概述以及当前的标准，并旨在特别指出机器人肝手术的未来方向。
与开放和腹腔镜手术相比，机器人肝手术是安全可行的，具有改善的短期术后结果，并且至少非劣效的肿瘤学结果。
在包括大肝切除术、胆道重建的广泛肝切除术和困难的后上段节段切除术在内的复杂病例中，机器人手术似乎是开放手术的合理替代选择，而不是腹腔镜手术的替代选择。
