Establishing a Robot-Assisted Liver Surgery Program: Early Experience from University Medical Center Ljubljana

Area of Science:

• Minimally Invasive Surgery
• Surgical Oncology
• Robotic Surgery

Background:

• Robot-assisted surgery offers advancements in minimally invasive liver resection.
• Implementing new surgical techniques requires careful planning and a phased approach.
• This study details the integration of a robotic platform for liver resections at a high-volume center.

Purpose of the Study:

• To describe the adoption and initial outcomes of robot-assisted liver resection.
• To evaluate the safety and efficacy of robotic surgery in liver disease treatment.

Main Methods:

• Retrospective analysis of prospectively collected data from 50 robot-assisted liver resections.
• Descriptive statistics were used to summarize operative and patient outcomes.
• Data included operative duration, blood loss, hospital stay, complications, and oncologic results.

Main Results:

• Median operative time was 166 minutes with average blood loss of 200 mL.
• Low rates of transfusion (8%), conversion to open surgery (2%), and 90-day mortality (0%).
• High R0 resection rate (88.2%) for malignant tumors; 10% of patients experienced Clavien-Dindo grade 3+ complications.

Conclusions:

• Robot-assisted liver surgery can be safely integrated into clinical practice.
• Successful implementation requires structured training, patient selection, and a stepwise approach.
• Robotic liver resection, while beneficial, remains a complex procedure demanding expertise.