Evidence map›Paper›PMID 42717141›Full record

SynthesisJournal of robotic surgery2026

Robotic repeat hepatectomy for recurrent liver tumors: a systematic review of contemporary evidence and technical strategies.

Nikolaos Machairas, Konstantinos Kossenas, Charalampos Theocharopoulos, Anna Paspala, Stylianos Kykalos, Georgios C Sotiropoulos

Abstract readSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Journal of robotic surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Nikolaos Machairas *2nd Department of Propaedeutic Surgery, National and Kapodistrian University of Athens, Medical School, Athens, 11527, Greece. nmachair@med.uoa.gr.
Konstantinos Kossenas *2nd Department of Propaedeutic Surgery, National and Kapodistrian University of Athens, Medical School, Athens, 11527, Greece.
Charalampos TheocharopoulosDepartment of Surgery, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
Anna PaspalaDepartment of Liver Transplantation and Hepatobiliary Surgery, National and Kapodistrian University of Athens, Athens, Greece.
Stylianos Kykalos2nd Department of Propaedeutic Surgery, National and Kapodistrian University of Athens, Medical School, Athens, 11527, Greece.
Georgios C SotiropoulosDepartment of Liver Transplantation and Hepatobiliary Surgery, National and Kapodistrian University of Athens, Athens, Greece.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Repeat hepatectomy is a potentially curative treatment for selected patients with recurrent liver malignancies but is technically demanding because of adhesions, distorted anatomy, and limited operative working space. Robotic platforms may help address some of these challenges, but evidence on robotic repeat hepatectomy (RRH) is limited. This study critically reviews comparative perioperative evidence and repeat-hepatectomy-specific technical strategies. This review was performed in accordance with the PRISMA 2020 guidelines. PubMed/MEDLINE, Scopus, and the Cochrane Library were searched for studies reporting RRH in adults. The primary perioperative synthesis was restricted to four comparative cohort studies. One technical case series and four case reports were analyzed separately as technical and hypothesis-generating evidence. Risk of bias was assessed using ROBINS-I and Joanna Briggs Institute critical appraisal tools. Nine studies published from 2022 to 2026 were included: four comparative cohort studies, one technical case series, and four case reports. The comparative cohorts included 234 participants, of whom 133 underwent RRH; five additional RRH patients were described in technical reports, giving 138 RRH patients across all designs. In the comparative cohorts, operative time ranged from 152 to 349 min and estimated blood loss from 0 to 284 mL. Three cohorts reported no robotic conversions, while one reported 1/11 (9.1%). Major morbidity ranged from 0% to 8.9%, 30-day mortality was 0% where reported, and 90-day mortality ranged from 0% to 1.8%. Technical reports demonstrated feasibility in selected caudate, posterosuperior, and central resections but were not used to infer safety or comparative effectiveness. All comparative studies had serious overall risk of bias. In selected patients treated at experienced hepatopancreatobiliary centers, comparative cohorts support the feasibility of RRH with acceptable short-term outcomes. Current evidence does not establish the superiority of robotics or of any specific robotic strategy. The potential contribution of robotics may be an extension of minimally invasive indications to selected complex repeat resections, but this remains to be tested in adequately adjusted, multicenter comparative studies with standardized technical and oncological reporting.

Indexed as

HepatectomyLiver NeoplasmsNeoplasm Recurrence, LocalReoperationRobotic Surgical ProceduresHumansOperative TimeCRLMhepatichepatocellularliverminimally invasiverecurrentredorobotic

Identifiers

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.