International Benchmark Values for Robotic Right Hepatectomy: Multicenter Study From 22 Expert Centers

Area of Science:

• Hepatobiliary Surgery
• Minimally Invasive Surgery
• Surgical Oncology

Background:

• Robotic liver surgery is an advancing minimally invasive technique.
• Established reference values are crucial for comparing robotic approaches to traditional methods.
• Expert centers are vital for developing benchmarks in complex procedures like robotic right hepatectomy.

Purpose of the Study:

• To establish benchmark values for robotic right hepatectomy (RRH) using a low-risk patient cohort.
• To compare RRH outcomes against laparoscopic and open right hepatectomy benchmarks.
• To identify key performance indicators for robotic liver surgery.

Main Methods:

• Analysis of consecutive patients undergoing robotic RH at 22 international expert centers (2018-2024).
• Inclusion of a low-risk cohort (n=172) without significant comorbidities.
• Derivation of 15 reference values and comparison with laparoscopic and open RH data.

Main Results:

• Key reference values established for operative time, conversion rates, bile leaks, and complications.
• Robotic RH demonstrated lower conversion and R1 rates compared to laparoscopic RH.
• Robotic RH showed lower rates of major complications and liver failure compared to open RH.

Conclusions:

• Robotic right hepatectomy offers significant advantages over laparoscopic and open techniques.
• RRH is emerging as a preferred minimally invasive option for liver tumors.
• This study provides essential benchmarks for the adoption and evaluation of RRH.