Robotic liver surgery: results for 70 resections.
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.
Giulianotti
Pier Cristoforo
PC
Department of Surgery, Division of General, Minimally Invasive, and Robotic Surgery, University of Illinois at Chicago, Chicago, IL 60612, USA. piercg@uic.edu
Coratti
Andrea
A
Sbrana
Fabio
F
Addeo
Pietro
P
Bianco
Francesco Maria
FM
Buchs
Nicolas Christian
NC
Annechiarico
Mario
M
Benedetti
Enrico
E
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