Robotic liver surgery from the patient’s perspective

Kelly J. Lafaro, Yuman Fong


Minimally invasive hepatobiliary surgery began in 1987 with the first laparoscopic cholecystectomy (1,2). Over the next two decades, the use of laparoscopy in liver resection was reported on by multiple groups (3-5). However, it was not until 2008, when the first consensus guidelines for laparoscopic liver surgery were published, that these new minimally invasive techniques were standardized (6). Despite advances in instrumentation including laparoscopic staplers and energy devices, laparoscopic liver resections were still limited by the rigid instruments and 2D vision. While the laparoscopic techniques were maturing, the first robotic cholecystectomies were performed by Himpens (7) and Gagner (8) in the early 1990s. This was followed by the release of the da Vinci robotic surgical system in Europe in 1999 and its approval by the Food and Drug Administration (FDA) in the United States in 2000.