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Exploring the feasibility of robotic liver resection in a limited resource setting

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Abstract

The transition from open hepatectomy to minimally invasive techniques has reduced morbidity and mortality. However, laparoscopic liver resection (LLR) requires substantial expertise. Robotic liver resection (RLR) combines minimal invasiveness with open surgical precision. It may facilitate complex procedures without the learning required for LLR. We evaluated RLR outcomes in a limited resource setting and assessed its efficacy and practicality. This retrospective study analyzed 67 robotic hepatectomies conducted from 2020 to 2023. Demographic, perioperative factors, and surgical outcomes were analyzed. Major hepatectomies were required in 46/67 (68.7%) patients who underwent RLR. No open conversions, 30-day mortalities, or readmissions occurred. Complications occurred in 7.4% of patients; major complications occurred in 5.9%. Learning curve analysis showed a negative correlation between operation sequence and operative time. Effective use of robotic technology combined with the expertise of well-trained surgeons facilitates successful execution of RLR with feasible surgical outcomes, even at smaller centers.

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No datasets were generated or analysed during the current study.

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Funding

This work was supported by the Dong-A University Research Fund. The Dong-A University research fund had no part in the design, execution, analysis, or writing of the study or the decision to submit for publication. No other entity had a role in funding, writing, designing, analyzing, or sponsoring the study.

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Authors and Affiliations

  1. Department of Surgery, Dong-A University College of Medicine, Dong-A University Medical Center, 26 Daesingongwon-ro, Seo-gu, Busan, 49201, Republic of Korea

    Eun Jeong Jang, Sung Hwa Kang & Kwan Woo Kim

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  1. Eun Jeong Jang
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  2. Sung Hwa Kang
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  3. Kwan Woo Kim
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Contributions

Conceptualization: EJJ; Methodology: EJJ; Formal analysis and investigation: SHK, KWK; Writing—original draft preparation: EJJ; Writing—review and editing: SHK, KWK; Funding acquisition: EJJ, Approved final script: EJJ, SHK, KWK.

Corresponding author

Correspondence to Kwan Woo Kim.

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Conflict of interest

The authors have no relevant financial or non-financial interests to disclose.

Ethical approval

This study was approved by the ethics committee of Dong-A University Hospital (IRB No. DAUH IRB-24-022). The requirement for informed consent was waived because of the retrospective nature of this study. The study was conducted in accordance with the principles of the Declaration of Helsinki.

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The requirement for informed consent was waived because of the retrospective nature of this study.

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Jang, E.J., Kang, S.H. & Kim, K.W. Exploring the feasibility of robotic liver resection in a limited resource setting. J Robotic Surg 18, 187 (2024). https://doi.org/10.1007/s11701-024-01901-1

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