Guadagni Simone, Comandatore Annalisa, Furbetta Niccolò, Di Franco Gregorio, Bechini Bianca, Vagelli Filippo, Ramacciotti Niccolò, Palmeri Matteo, Di Candio Giulio, Giovannetti Elisa, Morelli Luca
General Surgery Unit, Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, 56126 Pisa, Italy.
Department of Medical Oncology, Cancer Center Amsterdam, University Medical Center, 1081 Amsterdam, The Netherlands.
Life (Basel). 2024 Jul 19;14(7):894. doi: 10.3390/life14070894.
Liver resection is a critical surgical procedure for treating various hepatic pathologies. Minimally invasive approaches have gradually gained importance, and, in recent years, the introduction of robotic surgery has transformed the surgical landscape, providing potential advantages such as enhanced precision and stable ergonomic vision. Among robotic techniques, the single-site approach has garnered increasing attention due to its potential to minimize surgical trauma and improve cosmetic outcomes. However, the full extent of its utility and efficacy in liver resection has yet to be thoroughly explored.
We conducted a comprehensive systematic review to evaluate the current role of the single-site robotic approach in liver resection. A detailed search of PubMed was performed to identify relevant studies published up to January 2024. Eligible studies were critically appraised, and data concerning surgical outcomes, perioperative parameters, and post-operative complications were extracted and analyzed.
Our review synthesizes evidence from six studies, encompassing a total of seven cases undergoing robotic single-site hepatic resection (SSHR) using various versions of the da Vinci© system. Specifically, the procedures included five left lateral segmentectomy, one right hepatectomy, and one caudate lobe resection. We provide a summary of the surgical techniques, indications, selection criteria, and outcomes associated with this approach.
The single-site robotic approach represents an option among the minimally invasive approaches in liver surgery. However, although the feasibility has been demonstrated, further studies are needed to elucidate its optimal utilization, long-term outcomes, and comparative effectiveness against the other techniques. This systematic review provides valuable insights into the current state of single-site robotic liver resection and underscores the need for continued research in this rapidly evolving field.
肝切除术是治疗各种肝脏疾病的关键外科手术。微创方法逐渐变得重要，近年来，机器人手术的引入改变了手术格局，提供了诸如提高精度和稳定的人体工程学视野等潜在优势。在机器人技术中，单孔入路因其有可能将手术创伤降至最低并改善美容效果而受到越来越多的关注。然而，其在肝切除术中的全部效用和疗效尚未得到充分探索。
我们进行了一项全面的系统评价，以评估单孔机器人入路在肝切除术中的当前作用。对PubMed进行了详细检索，以识别截至2024年1月发表的相关研究。对符合条件的研究进行了严格评估，并提取和分析了有关手术结果、围手术期参数和术后并发症的数据。
我们的综述综合了六项研究的证据，共涵盖七例使用不同版本的达芬奇©系统进行机器人单孔肝切除术（SSHR）的病例。具体而言，手术包括五例左外叶切除术、一例右肝切除术和一例尾状叶切除术。我们总结了与该方法相关的手术技术、适应症、选择标准和结果。
单孔机器人入路是肝脏手术微创方法中的一种选择。然而，尽管已证明其可行性，但仍需要进一步研究以阐明其最佳应用、长期结果以及与其他技术相比的有效性。本系统评价为单孔机器人肝切除术的当前状态提供了有价值的见解，并强调了在这个快速发展的领域持续研究的必要性。
