title: Indications for liver surgery: laparoscopic or robotic approach.
abstract: Laparoscopic liver resections have been demonstrated to be safe and effective with the advantages of a shorter hospital stay, less blood loss, less adhesions and better postoperative recovery compared to open surgery. However, indications are usually confined to peripheral, small lesions, due to issues intrinsic to the approach. In the effort to overcome some of these technical limitations, robotic technology has been developed, with encouraging findings. We performed a review of the literature to assess the current indications for laparoscopic hepatic resections and to investigate the role of robotics in broadening the application of minimally invasive liver surgery. Although a paucity of data exists, especially regarding long-term oncological outcomes and specific comparisons with laparoscopy, robotics has been proved to facilitate several complex liver procedures, including parenchyma-saving resections. Thus, the number of patients who can benefit from less invasive, conservative approach is potentially increased.
authors.affiliation: Division of Oncological and Robotic Surgery, Department of Oncology, Careggi University Hospital, Florence, Italy, stefano.amore.b@gmail.com.
authors.forename: Stefano Amore
authors.initials: SA
authors.lastname: Bonapasta
authors.forename: Ilenia
authors.initials: I
authors.lastname: Bartolini
authors.forename: Paolo
authors.initials: P
authors.lastname: Checcacci
authors.forename: Francesco
authors.initials: F
authors.lastname: Guerra
authors.forename: Andrea
authors.initials: A
authors.lastname: Coratti
mesh_terms: D016063:Blood Loss, Surgical / Q000517:prevention & control; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D007902:Length of Stay; D008107:Liver Diseases / Q000473:pathology* / Q000601:surgery*; D008113:Liver Neoplasms / Q000473:pathology / Q000601:surgery; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000009:adverse effects / Q000379:methods; D061646:Operative Time; D061214:Patient Safety; D018579:Patient Selection; D011183:Postoperative Complications / Q000503:physiopathology / Q000628:therapy; D011379:Prognosis; D018570:Risk Assessment; D065287:Robotic Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D016896:Treatment Outcome