ASO Author Reflections: The Robotic Versus Laparoscopic Approach to Left and Extended Left Hepatectomy

Excerpt

The traditional open approach to liver resection has dominated the landscape of hepatobiliary surgery over the last century. Since the 1990s, with the introduction of the laparoscopic approach, many surgical subspecialties hurried to modify their technique to a point where the vast majority of abdominal operations can now be performed laparoscopically. The primary drivers of this evolution were the salutary benefits of laparoscopy compared with the open method, such as lower perioperative complications, less blood loss, decreased pain, lower narcotic requirement, better cosmesis, and earlier return to work without compromise to the oncological outcomes. As opposed to most surgical specialists, liver surgeons were more hesitant to adopt laparoscopy into daily practice, mainly due to inherent complexity of the operation, fear of uncontrollable bleeding, steep learning curve, and limited maneuverability of the instruments.¹ The advancements in robotics have paved the way for a new era in hepatobiliary surgery. The robotic platform offers technical versatility over laparoscopy along with attributes of a minimally invasive approach, which allow safe performance of liver resection in almost any complexity.^2‐5 Thus, a comparison between the two techniques is anticipated using a large multicentric database. …