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. 2025 Jan 27;17(3):415.
doi: 10.3390/cancers17030415.

Robotic Liver Resection for Hepatocellular Carcinoma: A Multicenter Case Series

Silvio Caringi  1   2 , Antonella Delvecchio  2 , Maria Conticchio  2 , Francesca Ratti  3   4 , Paolo Magistri  5 , Andrea Belli  6 , Graziano Ceccarelli  7 , Francesco Izzo  6 , Marcello Giuseppe Spampinato  8 , Nicola De'Angelis  9 , Patrick Pessaux  10 , Tullio Piardi  11 , Fabrizio Di Benedetto  5 , Luca Aldrighetti  3   4 , Riccardo Memeo  2
Affiliations

Robotic Liver Resection for Hepatocellular Carcinoma: A Multicenter Case Series

Silvio Caringi et al. Cancers (Basel). .

Abstract

Background: Liver resection is the standard treatment for resectable hepatocellular carcinoma (HCC). The advent of robotic surgery has extended its application in liver surgery, reducing post-operative complications without compromising oncological safety. This study is a retrospective series with the aim of analyzing the preoperative patient's and tumor's characteristics and evaluating intraoperative and post-operative data in terms of hospital stay, complications, and oncological radicality.

Methods: Data were collected from a multicenter retrospective database that includes 1070 consecutive robotic liver resections (RLRs) performed in nine European hospital centers from 2011 to 2023. Of the entire series, 343 liver resections were performed for HCC.

Results: A total of 247 patients (72.3%) had mono-focal lesions. Major hepatectomies and anatomical resections have been perfomed in 87% and 55% of patients, respectively. All 17 conversions (4.95%) were to the open approach. The operative mean time was 239.56 min and the estimated blood loss was 229.45 mL. The overall post-operative complication rate was 22.74%, but severe complications occurred in 4.08% of patients and one of them (0.29%) was reoperated on. The mean hospital stay was 5.82 days with a mean ICU stay of 0.9 days. Twenty-six resections (7.6%) were R1 parenchymal. Forty-six patients (4.08%) were readmitted to the hospital within 90 days after discharge and seventy-eight patients (22.74%) had disease recurrence. Total deaths included 36 (10.5%) patients with a 90-day mortality of 0.9%.

Conclusions: Robotic liver resection for HCC is feasible and safe when performed in experienced centers by surgeons who have completed the learning curve.

Keywords: hepatocellular carcinoma; liver resections; minimally invasive liver surgery; oncological outcome; robotic hepatectomy; robotic surgery.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Localization of single lesions. HA: Hepatic Artery; MPV: Main Portal Vein; RPV: Right Portal Vein; LPV: Left Portal Vein; RHV: Right Hepatic Vein; MHV: Middle Hepatic Vein; LHV: Left Hepatic Vein.
Figure 2
Figure 2
Localization of multiple lesions. HA: Hepatic Artery; MPV: Main Portal Vein; RPV: Right Portal Vein; LPV: Left Portal Vein; RHV: Right Hepatic Vein; MHV: Middle Hepatic Vein; LHV: Left Hepatic Vein.
See this image and copyright information in PMC

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