title: [Robotic-Assisted Liver Surgery].
abstract: BACKGROUND
  The advantages of minimally invasive liver resections for selected patients are evident. Robots provide new innovations that will influence minimally invasive liver surgery in the future. This article presents our initial experience with this technology in our patient population. Material und Methods: In 14 patients with benign or malignant liver tumours, robotic-assisted liver surgery was performed. Selection criteria were compensated liver function and resection of ≤ 3 liver segments. Chronic liver disease or previous abdominal surgery were no exclusion criteria.
  
  
  RESULTS
  Malignant liver tumours were removed in 10 patients (71%) and benign symptomatic liver tumors in 3 patients (21%), respectively, with histopathologically negative margins (R0). One patient suffering from HCC underwent intraoperative ablation. In one case (7%) conversion was necessary. Mean operation time was 296 min (120-458 min); mean estimated blood loss was 319 ± 298 ml. The mean hospital stay of the patients was 8 days (3-17 days). Three patients (21%) suffered from postoperative complications, which were manageable by conservative treatment (Clavien-Dindo I) in 2 cases (14%). One patient (7%) needed endoscopic treatment for postoperative bile leak (Clavien-Dindo III a). No patient died intra- or perioperatively.
  
  
  CONCLUSIONS
  Robotic-assisted liver surgery is a safe procedure, which provides patients with all benefits of minimally invasive surgery. This highly advanced technology requires surgeons to strive for an increasing level of specialisation, in addition to being well-trained in liver surgery. Hence, a clear definition of the procedures and standardised teaching programs are necessary.
authors.affiliation: Chirurgische Klinik, Universitätsklinikum Erlangen, Deutschland.
authors.forename: R
authors.initials: R
authors.lastname: Croner
authors.affiliation: Chirurgische Klinik, Universitätsklinikum Erlangen, Deutschland.
authors.forename: A
authors.initials: A
authors.lastname: Perrakis
authors.affiliation: Chirurgische Klinik, Universitätsklinikum Erlangen, Deutschland.
authors.forename: R
authors.initials: R
authors.lastname: Grützmann
authors.affiliation: Chirurgische Klinik, Universitätsklinikum Erlangen, Deutschland.
authors.forename: W
authors.initials: W
authors.lastname: Hohenberger
authors.affiliation: Chirurgische Klinik, Universitätsklinikum Erlangen, Deutschland.
authors.forename: M
authors.initials: M
authors.lastname: Brunner
mesh_terms: D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000473:pathology / Q000601:surgery*; D005260:Female; D005858:Germany; D006498:Hepatectomy / Q000295:instrumentation* / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000295:instrumentation* / Q000379:methods*; D007902:Length of Stay; D008099:Liver / Q000473:pathology; D008107:Liver Diseases / Q000473:pathology / Q000601:surgery*; D008113:Liver Neoplasms / Q000473:pathology / Q000556:secondary* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D065287:Robotic Surgical Procedures / Q000295:instrumentation* / Q000379:methods*; D013523:Surgical Equipment; D013525:Surgical Instruments