Time to take another look at perceived disadvantages of robotic hepatectomy
Robotic hepatectomy remains controversial to date, despite continuous advances in the technology and more surgeons gaining experience with the method. Melstrom et al. (1) recently published an interesting article in Hepatobiliary Surgery and Nutrition, titled “Selecting incision-dominant cases for robotic liver resection: towards outpatient hepatectomy with rapid recovery.” The authors evaluated 97 cases of robotically-assisted liver resection (RLR) arguing that it is difficult to reach the superior-posterior liver segments with the straight instruments used in conventional laparoscopic liver resection (LLR). The articulated instruments of the surgical robot are better suited for hepatectomies in these difficult-to-reach areas of the liver. They concluded that cases where the incision of an open approach would be large and affect recovery results in the highest likelihood of patients benefitting from a robotic approach. We think that the authors present an interesting perspective by focusing on the strong points of RLR compared to LLR.