Towards a Fully Robotic Surgery: Performing Robotic Major Liver Resection with No Table-side Surgeon.

BACKGROUND: Evidence has suggested that robotic system helps perform more major liver resections. However, the required table-side surgeon has remained a concern because of the uncertain performance and the incomplete control of console surgeon.

METHODS: Data were reviewed for consecutive 333 robotic liver resections, of which 56 patients underwent left liver resection with the usual setting, and 35 with no table-side surgeon.

RESULTS: No conversion was required in the setting with no table-side surgeon. The group without the table-side surgeon had similar complication rates, blood loss, and operative time compared to that of the normal settings, as well as focused analysis on major left hemihepatectomy.

CONCLUSION: Our data suggest that performing robotic major liver resection without the presence of the table-side surgeon is safe and feasible. The concise performance of robotic platforms might accelerate the machine learning process along with the ability to predict patterns of future autonomous surgery.