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Lai et al. Hepatoma Res 2017;3:278-83 Hepatoma Research
DOI: 10.20517/2394-5079.2017.37
www.hrjournal.net
Topic: Management of Huge and Advanced Hepatocellular Carcinoma Open Access

Robotic hepatectomy for hepatocellular

carcinoma: a clinical review

Eric C.H. Lai, Daniel T.M. Chung, Oliver C.Y. Chan, Chung Ngai Tang

Department of Surgery, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong, China.
Correspondence to: Dr. Eric C.H. Lai, Department of Surgery, Pamela Youde Nethersole Eastern Hospital, 3 Lok Man Road, Chai Wan, Hong Kong,
China. E-mail: elaichun@gmail.com
How to cite this article: Lai ECH, Chung DTM, Chan OCY, Tang CN. Robotic hepatectomy for hepatocellular carcinoma: a clinical review. Hepatoma
Res 2017;3:278-83.
ABSTRACT

Article history: The robotic surgical system was developed to overcome the disadvantages of conventional
Received: 21 Aug 2017 laparoscopic surgery. The use of robots in liver surgery was not well evaluated. This article aimed
First Decision: 20 Sep 2017 at reviewing robotic partial hepatectomy to conventional laparoscopic or open partial hepatectomy
Revised: 4 Oct 2017 in terms of perioperative, oncologic, and healthcare costs for hepatocellular carcinoma (HCC).
Studies were identified by searching MEDLINE and PubMed databases for articles from
Accepted: 26 Oct 2017 January 2004 to June 2017 using the keywords "laparoscopic hepatectomy", "robotic surgery",
Published: 27 Nov 2017
"robotic hepatectomy", and "hepatocellular carcinoma". Case reports were not included. The
Key words: open conversion rate, overall morbidity rate, and mortality rate of robotic partial hepatectomy
Laparoscopy, were reported as 0-14.3%, 0-27%, and 0-3%, respectively. Although little data regarding robotic
hepatectomy, approach for HCC have been reported, it appears to be better than open approach, particularly
robotic surgery, blood loss and hospital stay, and similar to conventional laparoscopic approach in terms of short
hepatocellular carcinoma term outcomes. The oncological outcomes were comparable to open or laparoscopic approach.
Well-known advantages of the robotic system allow resection of tumor location over posterior
and superior segments or major hepatectomy with more ease. The main disadvantage of robotic
approach was its high cost. In conclusion, oncological data from homogenous series of HCC after
robotic partial hepatectomy was needed. Robotic approach was safe to be an alternative option of
minimally invasive hepatectomy for HCC. Its future implementation will depend on the advantages
that it can provide over open or conventional laparoscopy approach.

INTRODUCTION development is also lag behind other gastrointestinal
organs’ development. These advanced techniques
The introduction of minimally invasive surgery (MIS) also require highly experienced laparoscopic skills.
has revolutionized surgical practice in the past 3 Increasing understanding of liver anatomy and
decades. MIS benefits patients in terms of better advancements in technology have facilitated the
pain control, shorter hospital stay, earlier recovery, development of MIS approach of hepatectomy [1,2] .
and better cosmesis [Table 1]. Traditionally, liver Two international expert consensus conferences
surgery is considered as one of the most challenging on laparoscopic partial hepatectomy were held in
surgeries among the abdominal procedures. Its MIS Louisville, KY, USA, in 2008 and in Morioka, Japan,

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