Minimally Invasive Surgery of the Liver

The Use of Robotics in Surgery of Benign Liver Diseases: A Systematic Review

BACKGROUND

Surgical treatment of benign liver diseases (BLD) remains a field of conflict, due to increased risk and high complication rate. However, the introduction of minimally invasive surgery has led to increased number of patients with BLD being treated surgically, with similar outcomes and fewer complications. Current data support the application of laparoscopic surgery (LS) and robotic surgery (RS) in surgical treatment of liver malignancies, but there are insufficient data concerning the application of robotic surgery in BLD. In the present systematic review, we aimed to evaluate the application of RS in BLD surgery.

METHODS

After a thorough search of Medline, Scopus, and Cochrane Library, 12 studies were considered eligible with a total number of 115 patients with BLD.

DISCUSSION

In brief, RS appears to be a safe and feasible option for BLD surgery. When compared to open surgery, RS is associated with lower blood loss, shorter length of stay, and fewer complication rate. Regarding LS, the peri- and postoperative outcomes were similar, but RS can overcome the technical limitations of LS. However, the cost of RS remains a major drawback in its widespread application.

CONCLUSIONS

Considering our findings, RS can be a safe and feasible option for BLD surgery, but further studies are needed to justify the introduction of RS in liver surgery and to define the type of patients that will benefit the most from it.

Treatment of metastatic colorectal cancer: innovations in surgical techniques

Liver metastases and peritoneal carcinomatosis are a particular focus of surgeons in improving survival in stage IV colorectal cancer patients, with laparotomy long being the means to undertake these operations. The Louisville statement published in 2008 was the first international consensus on indications for minimally invasive liver resection. Herein we review the progress in innovative surgical techniques, including minimally invasive liver resection, robot-assisted hepatectomy, and we also describe initial reports in pressurized intraperitoneal aerosol chemotherapy.