Robotic Surgery in Liver Transplantation and Resection

A robotic approach to the liver provides several technical advantages, compared to standard laparoscopy, that allow an easier access even to the so-called difficult segments. Although the instrumentation does not include liver-dedicated tools, the robotic platform ensures a safe dissection and good postoperative outcomes thanks to image magnification, stability, tremor filtration and seven degrees of instrument freedom. A potential advantage of a robotic approach has been claimed in the setting of cirrhotic patients thanks to easier vascular control. Robotic liver resection also represents a valuable alternative to loco-regional treatments and open surgery for bridging and downstaging strategies. In the setting of living donation, robotic donor surgery is still in its infancy and further data are awaited.