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Robotic Taj Mahal Hepatectomy for Hilar Cholangiocarcinoma
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Single port robotic hepatectomy: an initial European experience.

P A Holzner1, C Berlin2,3,4, S Fichtner-Feigl2

  • 1Department of General and Visceral Surgery, Center for Surgery, Medical Center and Faculty of Medicine, University of Freiburg, Hugstetterstraße 55, 79106, Freiburg, Germany. philipp.holzner@uniklinik-freiburg.de.

Surgical Endoscopy
|June 16, 2026
PubMed
Summary

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Single-Port Robotic Liver Surgery: A Pilot Feasibility Study of a Standardized Surgical Approach.

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Single port (SP) robotic hepatectomy is feasible in Europe. Experienced surgeons can perform this minimally invasive procedure with good outcomes, though larger studies are needed to confirm its role.

Area of Science:

  • Minimally Invasive Surgery
  • Surgical Oncology
  • Robotic Surgery

Background:

  • Single port (SP) robotic surgery represents an advancement in minimally invasive techniques.
  • Published evidence for SP robotic hepatectomy is limited, necessitating further investigation.
  • This study aimed to assess the early feasibility of SP robotic hepatectomy in a European setting.

Purpose of the Study:

  • To evaluate the feasibility of single port (SP) robotic hepatectomy in Europe.
  • To analyze surgical outcomes, including complications and length of stay.
  • To contribute to the understanding of SP robotic hepatectomy's potential role.

Main Methods:

  • A systematic data collection of true SP and SP plus one robotic hepatectomies was conducted across three European centers.
Keywords:
FeasibilityHepatectomyLiver resectionRoboticSingle port

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  • Data included patient demographics, surgical details, blood loss, postoperative complications (Clavien-Dindo and ISGLS criteria), and length of hospital stay.
  • The study period was from February to June 2025.

    • Main Results:

    • Twelve SP and SP plus one robotic hepatectomies were performed, with a median incision length of 3.5 cm.
    • No procedures required conversion to open surgery, with a median blood loss of 100 ml.
    • The median length of hospital stay was 3.5 days, and complications were generally low grade (two grade I, two grade II, one grade IIIa), with no ISGLS posthepatectomy complications.

    Conclusions:

    • Single port (SP) robotic hepatectomy is feasible when performed by experienced hepatobiliary surgeons.
    • Larger studies are required to establish the safety profile and definitive role of SP robotic hepatectomy.
    • Findings support the concept of tailored robotic-assisted surgery (T-RAS).