Evolution of Robotic-Assisted Hepatobiliary Surgery

Abstract

Robotic surgery has grown tremendously in the past decade and has been applied in many surgical specialties, including hepatobiliary surgery. The complexity associated with hepatobiliary surgery initially limited the growth of implementing the use of robotics; however, technological breakthroughs made to the robotic surgical system and the superior patient outcomes have contributed to its exponential growth in the field. This article explores the evolution of robotic-assisted hepatobiliary surgery, from the advancement of the robotic surgical system to the progression of techniques applied in hepatobiliary surgery, and how this positively affected patient outcomes.

Keywords: evolution of hepatobiliary surgery; evolution of liver surgery; history of robotic liver surgery; robotic-assisted liver surgery.

Figure 1

A search on PubMed for ‘Robotic Liver Surgery’ showed a rise in publications in robotic-assisted hepatobiliary surgery from 1986 to 2024.

Figure 2

Number of articles and the rise in publications.

Figure 3

Evolution of the Da Vinci surgical system (Intuitive Surgical, Sunnyvale, CA, USA).

Figure 4

Drawing of the rubber band suspension method [25]. (A) Stay sutures used to fix the resection margins, (B) One end of the rubber band is pulled out and fixed on abdominal wall, (C) traction applied for transection (D) area covered by gauze to prevent leakage of CO₂, where the rubber band is pulled out, (E) configuration of port sites.