International experts consensus guidelines on robotic liver resection in 2023

Area of Science:

• Hepatobiliary Surgery
• Minimally Invasive Surgery
• Surgical Technology

Background:

• Robotic liver resection (RLR) adoption is increasing, yet clinical practice variations and controversies persist.
• Previous consensus statements provide a foundation for current RLR practice.
• Advancements in robotic surgical systems offer potential benefits but require updated guidance.

Purpose of the Study:

• To update clinical recommendations for robotic liver resection (RLR).
• To provide expert guidance for improving outcomes in RLR procedures.
• To establish a consensus for safe and effective RLR clinical practice.

Main Methods:

• Formation of a guideline steering group and expert group comprising 29 international liver surgery and evidence-based medicine (EBM) specialists.
• Comprehensive review and analysis of relevant literature by an evidence evaluation group.
• Development of 14 recommendations following WHO Handbook for Guideline Development and Chinese guidelines, utilizing the GRADE method for 8 recommendations and expert consensus for the remaining 6.

Main Results:

• A total of 14 updated clinical recommendations for robotic liver resection (RLR) were generated.
• Eight recommendations were evidence-based, formulated using the GRADE method.
• Six recommendations were based on literature review and expert opinion due to limited EBM data.

Conclusions:

• This international expert consensus guideline offers crucial direction for the safe and effective clinical application of RLR.
• The guideline aims to standardize and enhance patient outcomes in robotic liver surgery.
• It also identifies key research directions for the future advancement of RLR.