To summarize and discuss current evidence on advanced liver procedures performed using the robotic approach.
Approach:
Literature Review: A narrative and critical review of literature addressing robotic surgery in complex hepatobiliary procedures was conducted using PubMed/MEDLINE, focusing on articles published between January 2000 and January 2026.
Key Findings:
Robotic surgery has been integrated into hepatobiliary practice since the first robotic liver resections were reported in 2003.
Technical complexity in liver surgery is influenced by factors such as lesion location, proximity to vascular structures, and underlying liver disease.
Robotic technology offers advantages like enhanced dexterity and stable visualization, which may facilitate complex procedures.
Difficulty scoring systems have been developed to better stratify operative complexity in robotic liver surgery.
Interpretation:
Advanced robotic liver surgery should be viewed as applying robotic technology to high-complexity scenarios rather than merely replicating major hepatectomy.
Limitations:
Existing difficulty scoring systems may not fully capture the specific technical features and advantages of robotic surgery.
Most scoring systems were originally developed for laparoscopic surgery and may not be entirely applicable to robotic settings.
Conclusion:
The review provides a structured overview of the current applications, limitations, and future directions of robotic liver surgery.
by Jacopo Mascherini, Cristiano Guidetti, Hasan Al Harakeh, Roberta Odorizzi, Paolo Magistri, Gian Piero Guerrini, Iswanto Sucandy, Fabrizio Di Benedetto
A large Epic Cosmos analysis linked vaginal estrogen prescribing with lower rates of sepsis, hospital admission, and death following recurrent urinary tract infection, but researchers cautioned that prescribing may also mark broader differences in care.
