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Ruff et al. Mini-invasive Surg 2024;8:12 Mini-invasive Surgery
DOI: 10.20517/2574-1225.2024.39

Review Open Access

Strategies to build a robotic liver surgery program

1
Samantha M. Ruff , Allan Tsung 2
1
Department of Surgery, Division of Surgical Oncology, The Ohio State University Wexner Medical Center and James
Comprehensive Cancer Center, Columbus, OH 43210, USA.
2
Department of Surgery, Division of Surgical Oncology, University of Virginia Health, Charlottesville, VA 22908, USA.
Correspondence to: Dr. Allan Tsung, Department of Surgery, Division of Surgical Oncology, University of Virginia Health, 1240
Lee St, Charlottesville, VA 22903, USA. E-mail: crf9aa@uvahealth.org

How to cite this article: Ruff SM, Tsung A. Strategies to build a robotic liver surgery program. Mini-invasive Surg 2024;8:12.
https://dx.doi.org/10.20517/2574-1225.2024.39

Received: 7 May 2024 First Decision: 2 Jul 2024 Revised: 8 Jul 2024 Accepted: 9 Jul 2024 Published: 15 Jul 2024
Academic Editors: Kit-fai Lee, Giulio Belli Copy Editor: Pei-Yun Wang Production Editor: Pei-Yun Wang

Abstract
Over the past few decades, an increasing proportion of abdominal surgeries are performed through minimally
invasive platforms. In contrast, adaptation of minimally invasive techniques for liver surgery has garnered slower
attraction due to the complexity and associated morbidity and mortality with these operations. Compared to
laparoscopy, the robotic-assisted surgical system provides a three-dimensional operative view and instruments
with articulation that mimic and extend wrist movement. These elements improve operative dexterity making
dissection and suturing easier. Additionally, robotic surgery improves operative ergonomics and decreases physical
and mental fatigue. Studies show that the robotic platform is safe and versatile with many technical advantages for
complex operations, improved short-term outcomes compared to open surgery, and comparable oncologic
outcomes. As such, hepatobiliary surgeons are increasingly adapting robotic techniques in their practice. It is
crucial that as more hospitals adopt this technology, patient safety monitoring and quality initiatives are
maintained. Establishing a robotic liver surgery program revolves around three pillars: designing a curriculum to
overcome the learning curve, building a strong clinical and administrative team, and appropriate patient selection.
Keywords: Robotic surgery, liver surgery, curriculum, learning curve

INTRODUCTION
Over the past few decades, an increasing proportion of abdominal surgeries are performed through
minimally invasive platforms. In contrast, adaptation of minimally invasive techniques for liver surgery has

© The Author(s) 2024. Open Access This article is licensed under a Creative Commons Attribution 4.0
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