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In summary, we here present our initial series of robotic resections of hilar cholangiocarcinoma. Our results
indicate that with adequate surgical experience, this operation can be performed safely with excellent
outcomes. The main limitation of this study is that it was not a comparative study: we did not compare our
results with those of an open surgery control group. Another limitation was the small cohort of 21 patients,
which is unsurprising given the rarity of this disease. However, this is the largest published Western cohort
of patients undergoing robotic surgery for Klatskin tumors and it presents various benefits in perioperative
outcomes without compromising oncological outcomes. As this technology keeps growing and advancing,
we believe that the use of a robotic platform will become an alternative approach, not only for major liver
operations but also for resection of hilar cholangiocarcinoma.

DECLARATIONS
Authors’ contributions
Made substantial contributions to the conception and design of the study and performed data analysis and
interpretation: Jacoby H, Rayman S, Ross S, Rosemurgy A, Sucandy I
Performed data acquisition and data analysis, and provided administrative, technical, and material support:
Crespo K, Syblis C

Availability of data and materials
Not applicable.

Financial support and sponsorship
Not applicable.

Conflicts of interest
Ross S: Reports educational (personal fees and non-financial support) relationship with Intuitive Surgical
Incorporated, outside the submitted work. All other authors declared that there are no conflicts of interest.

Ethical approval and consent to participate
All participants were properly consented, and the study was approved by the IRB (1302427).

Consent for publication
Not applicable.

Copyright
© The Author(s) 2022.

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