ROBOTIC LIVER RESECTION OF PRIMARY AND SECONDARY LIVER TUMOURS
Robotic liver resection is a minimally invasive surgical procedure used to remove cancerous tumours from the liver with the assistance of a robotic surgical system. It is performed for patients with primary liver tumours, such as hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (ICC), as well as secondary liver tumours (liver metastases), most commonly from colorectal cancer and other malignancies.
Robotic liver resection is performed under general anaesthesia with the patient positioned to provide optimal access to the liver. Several small incisions are made in the abdomen for the placement of robotic ports, through which a high-definition three-dimensional camera and robotic instruments are introduced. After docking the robotic system, the abdominal cavity is thoroughly explored to assess the liver, confirm tumour resectability, and exclude any unsuspected metastatic disease. The liver is then carefully mobilised, and intraoperative ultrasound may be used to accurately localise the tumour and define the planned line of resection. The hepatic blood vessels and bile ducts supplying the affected liver segment are meticulously identified, dissected, and controlled to minimise blood loss. The tumour-bearing portion of the liver is then precisely resected with adequate surgical margins while preserving as much healthy liver tissue as possible. Following tumour removal, meticulous haemostasis is achieved, bile leaks are assessed and managed if present, and a surgical drain may be placed when indicated. The resected specimen is retrieved through a small protected incision, the robotic instruments are withdrawn, and the port sites are closed, completing the procedure.
Robotic liver resection offers the benefits of minimally invasive surgery, including reduced blood loss, less postoperative pain, lower risk of wound complications, shorter hospital stay, faster recovery, and earlier return to normal activities. In appropriately selected patients, it provides oncological outcomes comparable to conventional open liver surgery while offering the advantages of advanced robotic technology. The choice of robotic resection depends on tumour size, number, location, liver function, and the patient’s overall medical condition.