Department of Surgical Oncology, The University of Texas MD Anderson Cancer Center, 1400 Pressler St., Unit 1484, Houston, TX, 77030, USA.
Langenbecks Arch Surg. 2022 Aug;407(5):1779-1787. doi: 10.1007/s00423-022-02523-7. Epub 2022 Apr 30.
Minimally invasive liver resection is associated with lower perioperative morbidity and shorter hospital stay. However, the added benefit of the robotic platform over conventional laparoscopy is a matter of ongoing investigation.
The purpose of this narrative review is to provide an up-to-date and balanced evaluation of the benefits and shortcomings of robotic liver surgery for the modern hepatobiliary surgeon.
Advantages of a robotic approach to liver resection include a shortened learning curve, the ability to complete more extensive or complex minimally invasive operations, and integrated fluorescence guidance. However, the robotic platform remains limited by a paucity of parenchymal transection devices, complete lack of haptic feedback, and added operating time associated with docking and instrument exchange. Like laparoscopic hepatectomy, robotic hepatectomy may provide patients with more rapid recovery and a shorter hospital stay, which can help offset the substantial costs of robot acquisition and maintenance. The oncologic outcomes of robotic hepatectomy appear to be equivalent to laparoscopic and open hepatectomy for appropriately selected patients.
微创肝切除术与较低的围手术期发病率和较短的住院时间相关。然而，机器人平台相对于传统腹腔镜的额外优势仍在不断研究中。
本叙述性综述的目的是为现代肝胆外科医生提供关于机器人肝手术的优势和不足的最新、平衡的评估。
机器人肝切除术的优点包括缩短学习曲线、能够完成更广泛或复杂的微创手术以及集成荧光引导。然而，机器人平台仍然受到实质脏器离断器械缺乏、完全缺乏触觉反馈以及与对接和器械更换相关的额外手术时间的限制。与腹腔镜肝切除术一样，机器人肝切除术可能为患者提供更快的恢复和更短的住院时间，这有助于抵消机器人购置和维护的巨额成本。对于选择合适的患者，机器人肝切除术的肿瘤学结果似乎与腹腔镜和开腹肝切除术相当。
