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Updated: May 31, 2025
Robotic Left Hepatectomy using Indocyanine Green Fluorescence Imaging for an Intrahepatic Complex Biliary Cyst
Published on: June 24, 2022
Postoperative Outcomes After Robotic Liver Resection of Caudate Lobe: A Systematic Review
Gabriela Del Angel Millan1,2, Gianluca Cassese1,2,3, Fabio Giannone1,2
1Division of Hepato-Pancreato-Biliary, Oncologic and Robotic Surgery, Azienda Ospedaliero-Universitaria SS. Antonio e Biagio e Cesare Arrigo, 15121 Alessandria, Italy.
Insights
Robotic resection of the caudate lobe of the liver appears safe and feasible. This systematic review of 110 patients found low rates of major complications and no perioperative deaths, suggesting it
Area of Science:
- Hepatobiliary Surgery
- Minimally Invasive Surgery
- Surgical Oncology
Background:
- Caudate lobe liver resection is technically demanding due to deep location and major vessel proximity.
- Evidence on the safety and efficacy of robotic caudate lobectomy is limited.
Purpose of the Study:
- To systematically review and report on the safety, technical feasibility, and postoperative outcomes of robotic caudate lobectomy.
Main Methods:
- Systematic review of MEDLINE and SCOPUS databases.
- Inclusion of studies published up to December 19, 2024.
- Analysis of data from 5 selected studies involving 110 patients.
Main Results:
- 56.3% of surgeries were for malignant tumors; tumor sizes ranged from 0.9-7.7 cm.
- Mean operative time was 184.5 min; mean blood loss was 95.5 mL.
- Median hospital stay was 4.2 days; 21.8% experienced complications (1.8% major); no conversions or perioperative deaths.
Conclusions:
- Robotic caudate lobectomy shows promise as a safe and feasible alternative in specialized centers.
- Current data comes from limited retrospective studies.
- Larger studies are required to validate these preliminary findings.
Abstract:
Background and Objectives: Resection of the caudate lobe of the liver is considered a highly challenging surgical procedure due to the deep anatomic location of this segment and the relationships with major vessels. There is no clear evidence about the safety and effectiveness of robotic resection of the caudate lobe. The aim of this systematic review was to report data about the safety, technical feasibility, and postoperative outcomes of robotic caudate lobectomy. Materials and Methods: A systematic review of the MEDLINE and SCOPUS databases was undertaken, including studies published until 19 December 2024. Results: A total of 5 studies including 110 patients were selected. Of these surgeries, 56.3% were performed for malignant tumors. Tumor size varied significantly between 0.9 and 7.7 cm in the largest diameter. The mean operative time was 184.5 min (range 70-522 min), and the estimated blood loss was 95.5 mL (range 10-1500 mL). The median hospital length of stay was 4.2 days (range 2-19 days) and no cases of conversion to open were reported. All the patients underwent R0 resection. In total, 24 out of 110 patients (21.8%) developed postoperative complications, with 1.8% of all patients developing a major complication (Clavien-Dindo classification ≥ III). No perioperative deaths were reported by the included studies. Conclusions: Few retrospective studies investigating the outcomes of robotic resection of the caudate lobe are currently available in the literature. From published data, it may be a safe and feasible alternative to open and laparoscopic caudate lobectomy in selected patients in referral HPB centers. Further studies with larger sample sizes are needed to confirm such preliminary findings.
