SG Leaders: Fabrizio Di Benedetto
Paolo Magistri
Summary:
To compare open to laparoscopic to robotic cases of patients treated for tumors larger than 10 cm, or
with exophytic growth, or infiltrating the diaphragm with the aim to demonstrate the non-inferiority of
robotic approach, the threshold of proficiency needed to treat this cases robotically, and the risk of
tumor rupture and, consequently, systemic and local recurrence.
Background/rationale
The recent Consensus Conference on Robotic liver surgery held in Paris in December 2023
highlighted from the current literature the limited feasibility of robotic approach for large liver lesions.
Moreover, some authors claim that robotic approach should be considered contraindicated in this
setting since it may lead to an increased risk of intraoperative advderse events, including tumor rupture
and seeding.
Objectives
To identify differences in intraoperative and post-operative outcomes between the three different
approaches, define a proficiency threshold for safe adoption of robotic approach in this setting, and
assess the non-inferiority of minimally invasive strategies compared to the standard open
Study design
Retrospective multicenter cohort study including adult patients that underwent liver resection for
tumors larger than 10 cm, or exophytic growth, or infiltrating the diaphragm, with either open,
laparoscopic or robotic approach.
