Short-Term Outcomes After Robotic Versus Open Liver Resection: A Systematic Review and Meta-analysis

Background Robotic liver surgery is a novel technique expanding the field of minimally invasive approaches. An increasing number of studies assess the outcomes of robotic liver resections (RLR). The aim of our meta-analysis is to provide an up-to-date comparison of RLR versus open liver resections (OLR), evaluating its safety and efficacy. Materials and Methods A systematic search of MEDLINE, Scopus, Google Scholar, Cochrane, and Clinicaltrials.gov for articles published from January 2000 until January 2022 was undertaken. Results Thirteen non-randomized retrospective and one prospective clinical study enlisting 1801 patients met our inclusion criteria, with 640 patients undergoing RLR and 1161 undergoing OLR. RLR resulted in significantly lower overall morbidity (p < 0.001), shorter length of hospital stay (p = 0.002), and less intraoperative blood loss (p < 0.001). Operative time was found to be significantly higher in the RLR group (p < 0.001). Blood transfusion requirements, R0 resection, and mortality rates presented no difference among the two groups. The cumulative rate of conversion was 5% in the RLR group. Conclusion The increasing experience in the implementation of the robot will undoubtedly generate more prospective randomized studies, necessary to assess its potential superiority over the traditional open approach, in a variety of hepatic lesions.