ArticleSurgical endoscopy2026
Does complexity compromise outcomes in robotic hepatectomy?
Article in Surgical endoscopy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
4 citing papers in PubMed.
- Robotic versus laparoscopic anatomical hepatectomy: a post hoc analysis of the ROC'N'ROLL randomized controlled trial.Surgical endoscopy · 2026Article
- Robotic hepatectomy across IWATE difficulty levels: a single-center experience of the first 100 cases.Journal of robotic surgery · 2026Article
- Safety of Simultaneous Robot-Assisted Resection of Colorectal Malignancy and Synchronous Liver Metastases.Journal of clinical medicine · 2026Article
- Pathologic Complete Response to Neoadjuvant Dual Checkpoint Blockade with Durvalumab Plus Tremelimumab in Advanced-Stage HCC: A Case Report.Journal of hepatocellular carcinoma · 2026Article
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Authors and funding
11 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundComplex hepatectomies are challenging procedures in minimally invasive liver surgery. While the feasibility of complex laparoscopic hepatectomies is widely accepted, there is still limited data using the robotic platform for technically difficult cases. This cohort study evaluated postoperative outcomes in high and low complexity resections.
methodsPatients undergoing robotic hepatectomy recorded in a prospective database between 2020 and 2024 were included. Outcomes were compared between resections with a high complexity (HC) and low complexity (LC) based on the IWATE difficulty score system. Factors associated with severe morbidity were explored using logistic regression analyses.
resultsOf 237 patients with a median age of 64 years (interquartile range 55-71), 125 patients had HC and 112 patients had LC resections. In the HC group, segmentectomies (n = 40, 32%) were the most frequently performed resections compared to non-anatomic hepatectomies (n = 97, 87%) in the LC group. The overall rate of postoperative morbidity was comparable between groups (comprehensive complication index 12.3 (standard deviation (SD) 21.6) vs. 7.5 (SD 17.6), P = 0.061), while operating time, blood loss, and rates of severe morbidity were higher in the HC group. There were no significant differences in achieving textbook outcome between groups (n = 88, 70% vs. n = 90, 80% P = 0.077). Major hepatectomy was identified as the sole independent risk factor for severe morbidity (OR 2.670, 95%CI 1.010-7.070, P = 0.048).
conclusionComplex robotic hepatectomies are safe and feasible in high-volume centers with high rates of achieving textbook outcome.
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