Current Advances and Benefits of Minimally Invasive Approaches in Hepatobiliary Surgery

Laparoscopic and robo2c surgery have demonstrated superior short-term outcomes
compared to open surgery, par2cularly with respect to intraopera2ve blood loss,
transfusion requirements, intensive care unit length of stay, overall hospital stay, and
postopera2ve morbidity. These approaches are further associated with accelerated
func2onal recovery, reduced postopera2ve pain, and improved cosme2c outcomes.
Beyond these periopera2ve benefits, accumula2ng evidence indicates that minimally
invasive approaches achieve oncological outcomes equivalent to those of open
surgery, with adequate resec2on margins and comparable survival rates in carefully
selected oncological indica2ons. They addi2onally facilitate earlier ini2a2on of
adjuvant therapy when clinically indicated.
With regard to major hepatectomies, mul2ple studies and meta-analyses have
established the feasibility and safety of minimally invasive resec2on when performed
at high-volume, specialized centers.
Robo2c surgery cons2tutes a further refinement of the minimally invasive paradigm.
Three-dimensional visualiza2on, enhanced ergonomics, and superior instrument
dexterity facilitate complex dissec2ons and contribute to broadening the indica2ons
for minimally invasive hepatobiliary surgery.
In conclusion, the minimally invasive approach has emerged as a credible and
validated alterna2ve to open surgery for an expanding range of hepa2c and biliary
procedures, con2ngent upon rigorous pa2ent selec2on and demonstrated surgical
exper2se.