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Defining Global Benchmarks for Robotic Liver Resections: An International Multicenter Study.
Brian K P Goh1,2, Iswanto Sucandy3, Darren W Chua1,2
1Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital and National Cancer Centre Singapore, Singapore.
Annals of Surgery
|July 28, 2025
Summary
This study establishes the first global benchmark outcomes for robotic liver resections (R-LR). These benchmarks provide a vital reference for auditing and improving R-LR quality worldwide.
Area of Science:
- Hepatobiliary Surgery
- Minimally Invasive Surgery
- Robotic Surgery
Background:
- Robotic liver resections (R-LR) are increasingly adopted.
- Benchmark outcomes exist for laparoscopic liver resections (L-LR), but not for R-LR.
- Establishing R-LR benchmarks is crucial for quality assessment.
Purpose of the Study:
- To establish global benchmark outcome indicators for robotic liver resections (R-LR).
- To provide a reference for auditing and improving R-LR quality.
- To define best achievable outcomes for specific R-LR procedures.
Main Methods:
- Post hoc analysis of a multicenter database (5,213 patients, 51 centers, 2016-2022).
- Established benchmark cutoffs for 16 outcome indicators of low-risk R-LR.
- Utilized the 75th percentile of individual center medians as benchmark cutoffs.
- Focused on four procedures: left lateral sectionectomy (LLS/H23), left hepatectomy (LH/H234±1), right hepatectomy (RH/H5678±1), and right posterior sectionectomy (RPS/H67).
Main Results:
- Analyzed 1,654 R-LR cases from 24 expert centers.
- Identified 518 (31.3%) low-risk benchmark cases.
- Established benchmarks for operation time, open conversion rate, blood loss, transfusion rate, major morbidity, 90-day mortality, and textbook outcomes for LLS, LH, RH, and RPS.
Conclusions:
- The study successfully established the first global benchmark values for robotic liver resections (R-LR).
- These benchmarks serve as an up-to-date reference for auditing and quality assessment in R-LR.
- Provides a foundation for standardizing and improving R-LR outcomes globally.
