Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
Surgical Endoscopy
Published in: Surgical Endoscopy 3/2016

01-03-2016 | Review

A systematic review of robotic-assisted liver resection and meta-analysis of robotic versus laparoscopic hepatectomy for hepatic neoplasms

Authors: Jianguo Qiu, Shuting Chen, Du Chengyou

Published in: Surgical Endoscopy | Issue 3/2016

Login to get access

Abstract

Background

Robotic-assisted liver resection (RALR) was introduced as procedures of overcoming the limitations of traditional laparoscopic liver resection (LLR). The aim of this review was to evaluate the surgical results of RALR from all published studies and the results of comparative studies of RALR versus LLR for hepatic neoplasm.

Methods

Eligible studies involved RALR that published between January 2001 and December 2014 were reviewed systematically. Comparisons between RALS and LLR were pooled and analyzed by meta-analytical techniques using random- or fixed-effects models, as appropriate.

Results

In total, 29 studies, involving 537 patients undergoing RALR, were identified. The most common RALR procedure was a wedge resection and segmentectomy (28.67 %), followed by right hepatectomy (17.88 %), left lateral sectionectomy (13.22 %), and bisegmentectomy (9.12 %). The conversion and complication rates were 5.59 and 11.36 %, respectively. The most common reasons for conversion were bleeding (46.67 %) and unclear tumor margin (33.33 %). Intracavitary fluid collections and bile leaks (40.98 %) were the most frequently occurring morbidities. Nine studies, involving 774 patients, were included in meta-analysis. RALR had a longer operative time compared with LLR [mean difference (MD) 48.49; 95 % confidence interval (CI) 22.49–74.49 min; p = 0.0003]. There were no significant differences between the two groups in blood loss [MD 31.53; 95 % CI −14.74 to 77.79 mL; p = 0.18], hospital stay [MD 0.13; 95 % CI −0.54 to 0.80 days; p = 0.18], postoperative overall morbidity [odds ratio (OR) 0.76; 95 % CI 0.49–1.19; p = 0.23], and surgical margin status (OR 0.61; 95 % CI 0.33–1.12; p = 0.11); cost was greater than robotic surgery (p = 0.001).

Conclusion

RALR and LLR display similar safety, feasibility, and effectiveness for hepatectomies, but further studies are needed before any final conclusion can be drawn, especially in terms of oncologic and cost-effectiveness outcomes.
Literature
1.
Nguyen KT, Gamblin TC, Geller DA (2009) World review of laparoscopic liver resection—2,804 patients. Ann Surg 250:831–841CrossRefPubMed
2.
Pilgrim CH, To H, Usatoff V, Evans PM (2009) Laparoscopic hepatectomy is a safe procedure for cancer patients. HPB (Oxford) 11:247–251CrossRef
3.
Simillis C, Constantinides VA, Tekkis PP, Darzi A, Lovegrove R, Jiao L, Antoniou A (2007) Laparoscopic versus open hepatic resections for benign and malignant neoplasms-a meta-analysis. Surgery 141:203–211CrossRefPubMed
4.
Iwahashi S, Shimada M, Utsunomiya T, Imura S, Morine Y, Ikemoto T, Arakawa Y, Mori H, Kanamoto M, Yamada S (2014) Laparoscopic hepatic resection for metastatic liver tumor of colorectal cancer: comparative analysis of short- and long-term results. Surg Endosc 28:80–84CrossRefPubMed
5.
Buchs NC, Volonte F, Pugin F, Toso C, Fusaglia M, Gavaghan K, Majno PE, Peterhans M, Weber S, Morel P (2013) Augmented environments for the targeting of hepatic lesions during image-guided robotic liversurgery. J Surg Res 184:825–831CrossRefPubMed
6.
Sugimoto M, Tanaka K, Matsuoka Y, Man-i M, Morita Y, Tanaka S, Fujiwara S, Azuma T (2011) da Vinci robotic single-incision cholecystectomy and hepatectomy using single- channel GelPort access. J Hepatobiliary Pancreat Sci 18:493–498CrossRefPubMed
7.
Tomulescu V, Stănciulea O, Bălescu I, Vasile S, Tudor S, Gheorghe C, Vasilescu C, Popescu I (2009) First year experience of robotic-assisted laparoscopic surgery with 153 cases in a general surgery department: indications, technique and results. Chirurgia (Bucur) 104:141–150
8.
Ito M, Asano Y, Shimizu T, Uyama I, Horiguchi A (2014) Comparison of standard laparoscopic distal pancreatectomy with minimally invasive distal pancreatectomy using the da Vinci system. Hepatogastroenterology 61:493–496PubMed
9.
Inoue K, Ashida S, Fukuhara H, Iiyama T, Miyamura M, Kurabayashi A, Furihata M, Shuin T (2013) Application of 5-aminolevulinic acid-mediated photodynamic diagnosis to robot-assisted laparoscopic radical prostatectomy. Urology 82:1175–1178CrossRefPubMed
10.
Shin JW, Kim J, Kwak JM, Hara M, Cheon J, Kang SH, Kang SG, Stevenson AR, Coughlin G, Kim SH (2014) First report: robotic pelvic exenteration for locally advanced rectal cancer. Colorectal Dis 16:09–14CrossRef
11.
Ramzy D, Trento A, Cheng W, De Robertis MA, Mirocha J, Ruzza A, Kass RM (2014) Three hundred robotic-assisted mitral valve repairs: the Cedars-Sinai experience. J Thorac Cardiovasc Surg 147:228–235CrossRefPubMed
12.
Mann B, Virakas G, Blase M, Soenmez M (2013) Robotics-assisted laparoscopic colorectal resection. Chirurg 84:665–672CrossRefPubMed
13.
Ryska M, Fronek J, Rudis J, Jurenka B, Langer D, Pudil J (2006) Manual and robotic laparoscopic liver resection. Two case reviews. Rozhl Chir 85:511–516PubMed
14.
Vasile S, Sgarbură O, Tomulescu V, Popescu I (2008) The robotic-assisted left lateral hepatic segmentectomy: the next step. Chirurgia (Bucur) 103:401–405
15.
Choi SB, Park JS, Kim JK, Hyung WJ, Kim KS, Yoon DS, Lee WJ, Kim BR (2008) Early experiences of robotic-assisted laparoscopic liver resection. Yonsei Med J 49:632–638PubMedCentralCrossRefPubMed
16.
Patriti A, Ceccarelli G, Bartoli A, Spaziani A, Lapalorcia LM, Casciola L (2009) Laparoscopic and robot-assisted one-stage resection of colorectal cancer with synchronous liver metastases: a pilot study. J Hepatobiliary Pancreat Surg 16:450–457CrossRefPubMed
17.
Machado MA, Makdissi FF, Surjan RC, Abdalla RZ (2009) First robotic-assisted laparoscopic liver resection in Latin America. Arq Gastroenterol 46:78–80CrossRefPubMed
18.
19.
Giulianotti PC, Sbrana F, Bianco FM, Addeo P (2010) Robot-assisted laparoscopic extended right hepatectomy with biliary reconstruction. J Laparoendosc Adv Surg Tech A 20:159–163CrossRefPubMed
20.
21.
Strasberg S, Belghiti J, Clavien P (2000) IHPBA Brisbane 2000 terminology of liver anatomy and resections. HPB (Oxford) 2:333–339
22.
Dindo D, Demartines N, Clavien PA (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 240:205–213PubMedCentralCrossRefPubMed
23.
Wittekind C, Compton C, Quirke P, Nagtegaal I, Merkel S, Hermanek P, Sobin LH (2009) A uniform residual tumor (R) classification: integration of the R classification and the circumferential margin status. Cancer 115:3483–3488CrossRefPubMed
24.
Stang A (2010) Critical evaluation of the Newcastle–Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses. Eur J Epidemiol 25:603–605CrossRefPubMed
25.
Clarke M, Horton R (2001) Bringing it all together: Lancet-Cochrane collaborate on systematic reviews. Lancet 357:1728CrossRefPubMed
26.
Stroup DF, Berlin JA, Morton SC, Olkin I, Williamson GD, Rennie D, Moher D, Becker BJ, Sipe TA, Thacker SB (2000) Meta-analysis of observational studies in epidemiology: a proposal for reporting. Meta-analysis of observational studies in epidemiology (MOOSE) group. JAMA 283:2008–2012CrossRefPubMed
27.
Giulianotti PC, Coratti A, Sbrana F, Addeo P, Bianco FM, Buchs NC, Annechiarico M, Benedetti E (2011) Robotic liver surgery: results for 70 resections. Surgery 149:29–39CrossRefPubMed
28.
Chan OC, Tang CN, Lai EC, Yang GP, Li MK (2011) Robotic hepatobiliary and pancreatic surgery: a cohort study. J Hepatobiliary Pancreat Sci 18:471–480CrossRefPubMed
29.
Giulianotti PC, Sbrana F, Coratti A, Bianco FM, Addeo P, Buchs NC, Ayloo SM, Benedetti E (2011) Totally robotic right hepatectomy: surgical technique and outcomes. Arch Surg 146:844–850CrossRefPubMed
30.
Lai EC, Tang CN, Yang GP, Li MK (2011) Multimodality laparoscopic liver resection for hepatic malignancy from conventional total laparoscopic approach to robot-assisted laparoscopic approach. Int J Surg 9:324–328CrossRefPubMed
31.
Casciola L, Patriti A, Ceccarelli G, Bartoli A, Ceribelli C, Spaziani A (2011) Robot-assisted parenchymal-sparing liver surgery including lesions located in the posterosuperior segments. Surg Endosc 25:3815–3824CrossRefPubMed
32.
Ji WB, Wang HG, Zhao ZM, Duan WD, Lu F, Dong JH (2011) Robotic-assisted laparoscopic anatomic hepatectomy in China: initial experience. Ann Surg 253:342–348CrossRefPubMed
33.
Wakabayashi G, Sasaki A, Nishizuka S, Furukawa T, Kitajima M (2011) Our initial experience with robotic hepato-biliary-pancreatic surgery. J Hepatobiliary Pancreat Sci 18:481–487CrossRefPubMed
34.
Holloway RW, Brudie LA, Rakowski JA, Ahmad S (2011) Robotic-assisted resection of liver and diaphragm recurrent ovarian carcinoma: description of technique. Gynecol Oncol 120:419–422CrossRefPubMed
35.
Giulianotti PC, Addeo P, Bianco FM (2011) Robotic right hepatectomy for giant hemangioma in a Jehovah’s Witness. J Hepatobiliary Pancreat Sci 18:112–118CrossRefPubMed
36.
Lai EC, Tang CN, Li MK (2012) Robot-assisted laparoscopic hemi-hepatectomy: technique and surgical outcomes. Int J Surg 10:11–15CrossRefPubMed
37.
Choi GH, Choi SH, Kim SH, Hwang HK, Kang CM, Choi JS, Lee WJ (2012) Robotic liver resection: technique and results of 30 consecutive procedures. Surg Endosc 26:2247–2258CrossRefPubMed
38.
Giulianotti PC, Tzvetanov I, Jeon H, Bianco F, Spaggiari M, Oberholzer J, Benedetti E (2012) Robot-assisted right lobe donor hepatectomy. Transpl Int 25:e5–e9CrossRefPubMed
39.
Kandil E, Noureldine SI, Saggi B, Buell JF (2013) Robotic liver resection: initial experience with three-arm robotic and single-port robotic technique. JSLS 17:56–62PubMedCentralCrossRefPubMed
40.
Packiam V, Bartlett DL, Tohme S, Reddy S, Marsh JW, Geller DA, Tsung A (2012) Minimally invasive liver resection: robotic versus laparoscopic left lateral sectionectomy. J Gastrointest Surg 16:2233–2238PubMedCentralCrossRefPubMed
41.
Lai EC, Yang GP, Tang CN (2013) Robot-assisted laparoscopic liver resection for hepatocellular carcinoma: short-term outcome. Am J Surg 205:697–702CrossRefPubMed
42.
Troisi RI, Patriti A, Montalti R, Casciola L (2013) Robot assistance in liver surgery: a real advantage over a fully laparoscopic approach? Results of comparative biinstitutional analysis. Int J Med Robot 9:160–166CrossRefPubMed
43.
Tsung A, Geller DA, Sukato DC, Sabbaghian S, Tohme S, Steel J, Marsh W, Reddy SK, Bartlett DL (2014) Robotic versus laparoscopic hepatectomy: a matched comparison. Ann Surg 259:549–555CrossRefPubMed
44.
Spampinato MG, Coratti A, Bianco L, Caniglia F, Laurenzi A, Puleo F, Ettorre GM, Boggi U (2014) Perioperative outcomes of laparoscopic and robot-assisted major hepatectomies: an Italian multi-institutional comparative study. Surg Endosc 28:2973–2979CrossRefPubMed
45.
Wu YM, Hu RH, Lai HS, Lee PH (2014) Robotic-assisted minimally invasive liver resection. Asian J Surg 37:53–57CrossRefPubMed
46.
Tranchart H, Ceribelli C, Ferretti S, Dagher I, Patriti A (2014) Traditional versus robot-assisted full laparoscopic liver resection: a matched-pair comparative study. World J Surg 38:2904–2909CrossRefPubMed
47.
Yu YD, Kim KH, Jung DH, Namkoong JM, Yoon SY, Jung SW, Lee SK, Lee SG (2014) Robotic versus laparoscopic liver resection: a comparative study from a single center. Langenbecks Arch Surg 399:1039–1045CrossRefPubMed
48.
Cai X, Li Z, Zhang Y, Yu H, Yu H, Liang X, Jin R, Luo F (2014) Laparoscopic liver resection and the learning curve: a 14-year, single-center experience. Surg Endosc 28:1334–1341CrossRefPubMed
49.
Long TC, Bac NH, Thuan ND, le Dat T, Viet DQ, le Chuong CH (2014) Laparoscopic liver resection: 5-year experience at a single center. Surg Endosc 28:796–802PubMedCentralCrossRefPubMed
50.
Jung KU, Kim HC, Cho YB, Kwon CH, Yun SH, Heo JS, Lee WY, Chun HK (2014) Outcomes of simultaneous laparoscopic colorectal and hepatic resection for patients with colorectal cancers: a comparative study. J Laparoendosc Adv Surg Tech A 24:229–235CrossRefPubMed
51.
Fang C, Hua J, Li J, Zhen J, Wang F, Zhao Q, Shuang J, Du J (2014) Comparison of long-term results between laparoscopy- assisted gastrectomy and opengastrectomy with D2 lymphadenectomy for advanced gastric cancer. Am J Surg 208:391–396CrossRefPubMed
52.
Chan AC, Poon RT, Cheung TT, Chok KS, Dai WC, Chan SC, Lo CM (2014) Laparoscopic versus open liver resection for elderly patients with malignant liver tumors: a single-center experience. J Gastroenterol Hepatol 29:1279–1283CrossRefPubMed
53.
Boggi U, Caniglia F, Amorese G (2014) Laparoscopic robot-assisted major hepatectomy. J Hepatobiliary Pancreat Sci 21:3–10CrossRefPubMed
54.
Pelletier JS, Gill RS, Shi X, Birch DW, Karmali S (2013) Robotic-assisted hepatic resection: a systematic review. Int J Med Robot 9:262–267CrossRefPubMed
55.
Reggiani P, Antonelli B, Rossi G (2013) Robotic surgery of the liver: Italian experience and review of the literature. Ecancermedicalscience 7:358PubMedCentralPubMed
56.
57.
58.
Kitagawa M, Dokko D, Okamura AM, Yuh DD (2005) Effect of sensory substitution on suture-manipulation forces for robotic surgical systems. J Thorac Cardiovasc Surg 129:151–158CrossRefPubMed
59.
Hashizume M, Shimada M, Tomikawa M, Ikeda Y, Takahashi I, Abe R, Koga F, Gotoh N, Konishi K, Maehara S, Sugimachi K (2002) Early experiences of endoscopic procedures in general surgery assisted by a computer-enhanced surgical system. Surg Endosc 16:1187–1191CrossRefPubMed
60.
Hashizume M, Konishi K, Tsutsumi N, Yamaguchi S, Shimabukuro R (2002) A new era of robotic surgery assisted by a computer-enhanced surgical system. Surgery 131:S330–S333CrossRefPubMed
Metadata
Title
A systematic review of robotic-assisted liver resection and meta-analysis of robotic versus laparoscopic hepatectomy for hepatic neoplasms
Authors
Jianguo Qiu
Shuting Chen
Du Chengyou
Publication date
01-03-2016
Publisher
Springer US
Published in
Surgical Endoscopy / Issue 3/2016
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-015-4306-7

Other articles of this Issue 3/2016

Surgical Endoscopy 3/2016 Go to the issue

OriginalPaper

Predictive value of background experiences and visual spatial ability testing on laparoscopic baseline performance among residents entering postgraduate surgical training

OriginalPaper

Validity evidence for a new portable, lower-cost platform for the fundamentals of endoscopic surgery skills test

Review

A systematic review of performance assessment tools for laparoscopic cholecystectomy

Dynamic Manuscript

Safety and feasibility of endoscopic biliary radiofrequency ablation treatment of extrahepatic cholangiocarcinoma

OriginalPaper

Laparoscopic repair of hiatal hernia after minimally invasive esophagectomy

OriginalPaper

Evaluating long-term attachment of a novel endoclip in porcine stomachs: a prospective study of initial deployment success and clip retention rates at different regions of the stomachs