Robotic vs Open Hepatectomy: A Systematic Review and Meta-Analysis of Short-Term Outcomes

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INTRODUCTION: Robotic liver operation is a novel technique expanding the field of minimally invasive approach. An increasing number of studies assess the outcomes of robotic liver resection (RLR). The aim of our meta-analysis is to provide an up-to-date comparison of RLR vs open liver resection (OLR), evaluating its safety and efficacy. METHODS: A systematic search of Medline, Scopus, Google Scholar, Cochrane, and Clinicaltrials.gov for articles published from January 2000 until January 2022 was undertaken. Thirteen nonrandomized retrospective and 1 prospective clinical study enlisting 1,801 patients met our inclusion criteria, with 640 patients undergoing RLR and 1,161 undergoing OLR. RESULTS: RLR resulted in significantly lower overall morbidity (p < 0.001), shorter length of hospital stay (p = 0.002), and less intraoperative blood loss (p < 0.001). Operative time was found to be significantly higher in the RLR group (p < 0.001). Blood transfusion requirement, R0 resection, and mortality rate presented no difference among the 2 groups. The cumulative rate of conversion was 5% in the RLR group. CONCLUSION: The increasing experience in the implementation of the robot will undoubtedly generate more prospective randomized studies, necessary to assess its potential superiority over the traditional open approach, in a variety of hepatic lesions.

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