title: Robotic liver surgery: results for 70 resections.
abstract: BACKGROUND
  Robotic surgery is gaining popularity for digestive surgery; however, its use for liver surgery is reported scarcely. This article reviews a surgeon's experience with the use of robotic surgery for liver resections.
  
  
  METHODS
  From March 2002 to March 2009, 70 robotic liver resections were performed at 2 different centers by a single surgeon. The surgical procedure and postoperative outcome data were reviewed retrospectively.
  
  
  RESULTS
  Malignant tumors were indications for resections in 42 (60%) patients, whereas benign tumors were indications in 28 (40%) patients. The median age was 60 years (range, 21-84) and 57% of patients were female. Major liver resections (≥ 3 liver segments) were performed in 27 (38.5%) patients. There were 4 conversions to open surgery (5.7%). The median operative time for a major resection was 313 min (range, 220-480) and 198 min (range, 90-459) for minor resection. The median blood loss was 150 mL (range, 20-1,800) for minor resection and 300 mL (range, 100-2,000) for major resection. The mortality rate was 0%, and the overall rate of complications was 21%. Major morbidity occurred in 4 patients in the major hepatectomies group (14.8%) and in 4 patients in the minor hepatectomies group (9.3%). All complications were managed conservatively and none required reoperation.
  
  
  CONCLUSIONS
  This preliminary experience shows that robotic surgery can be used safely for liver resections with a limited conversion rate, blood loss, and postoperative morbidity. Robotics offers a new technical option for minimally invasive liver surgery.
authors.affiliation: Department of Surgery, Division of General, Minimally Invasive, and Robotic Surgery, University of Illinois at Chicago, Chicago, IL 60612, USA. piercg@uic.edu
authors.forename: Pier Cristoforo
authors.initials: PC
authors.lastname: Giulianotti
authors.forename: Andrea
authors.initials: A
authors.lastname: Coratti
authors.forename: Fabio
authors.initials: F
authors.lastname: Sbrana
authors.forename: Pietro
authors.initials: P
authors.lastname: Addeo
authors.forename: Francesco Maria
authors.initials: FM
authors.lastname: Bianco
authors.forename: Nicolas Christian
authors.initials: NC
authors.lastname: Buchs
authors.forename: Mario
authors.initials: M
authors.lastname: Annechiarico
authors.forename: Enrico
authors.initials: E
authors.lastname: Benedetti
mesh_terms: D000328:Adult; D000368:Aged; D016063:Blood Loss, Surgical / Q000503:physiopathology; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D006801:Humans; D007902:Length of Stay; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000295:instrumentation / Q000379:methods; D009367:Neoplasm Staging; D010149:Postoperative Pain / Q000503:physiopathology; D018579:Patient Selection; D011183:Postoperative Complications / Q000503:physiopathology / Q000601:surgery; D012086:Reoperation; D012189:Retrospective Studies; D018570:Risk Assessment; D012371:Robotics / Q000379:methods*; D015996:Survival Rate; D016896:Treatment Outcome; D014481:United States; D055815:Young Adult