Moritz Schmelzle1, Felix Krenzien1, Wenzel Schöning1, Johann Pratschke2. 1. Chirurgische Klinik, Campus Charité Mitte | Campus Virchow-Klinikum, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Deutschland. 2. Chirurgische Klinik, Campus Charité Mitte | Campus Virchow-Klinikum, Charité - Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Deutschland. johann.pratschke@charite.de.
Abstract
BACKGROUND: Minimally invasive liver surgery is now the standard procedure at experienced centers, whereby the techniques and strategies are continuously evolving. MATERIAL AND METHODS: An analysis of English language literature on minimally invasive and robotic liver surgery was performed. The current scientific status was summarized and evaluated on the basis of experience at our own center. RESULTS: The advantages of the minimally invasive technique compared to the conventional open technique are shown in liver surgery by improved perioperative results. Concerns about intraoperative complications and possible compromises in oncological radicality have been addressed in a number of publications. First reports on the robot-assisted technique seem to confirm the known advantages of laparoscopic liver surgery. The data available on robot-assisted liver surgery are still limited due to the short period of experience of a few centers and do not yet allow final conclusions; however, an increase in intraoperative safety and an expansion of the surgical spectrum towards highly complex liver resections seems likely. CONCLUSION: Even during the learning curve the known advantages of laparoscopic liver surgery seem to be confirmed also for robot-assisted liver surgery. According to the center's own experience, minimally invasive liver surgery will in future be meaningfully supplemented by robotic technology. In particular, technically highly complex resections with reconstruction are made possible.
BACKGROUND: Minimally invasive liver surgery is now the standard procedure at experienced centers, whereby the techniques and strategies are continuously evolving. MATERIAL AND METHODS: An analysis of English language literature on minimally invasive and robotic liver surgery was performed. The current scientific status was summarized and evaluated on the basis of experience at our own center. RESULTS: The advantages of the minimally invasive technique compared to the conventional open technique are shown in liver surgery by improved perioperative results. Concerns about intraoperative complications and possible compromises in oncological radicality have been addressed in a number of publications. First reports on the robot-assisted technique seem to confirm the known advantages of laparoscopic liver surgery. The data available on robot-assisted liver surgery are still limited due to the short period of experience of a few centers and do not yet allow final conclusions; however, an increase in intraoperative safety and an expansion of the surgical spectrum towards highly complex liver resections seems likely. CONCLUSION: Even during the learning curve the known advantages of laparoscopic liver surgery seem to be confirmed also for robot-assisted liver surgery. According to the center's own experience, minimally invasive liver surgery will in future be meaningfully supplemented by robotic technology. In particular, technically highly complex resections with reconstruction are made possible.
Entities:
Keywords:
Da Vinci liver resection; Hepatobiliary surgery; Laparoscopic liver surgery; Minimally invasive liver surgery; Robotic-assisted liver surgery
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