**7. Emerging technologies**

study demonstrated that while perioperative costs are higher with the robot, the overall total direct hospital costs are lower at least in part due to the decrease length of stay with robotic minimally invasive resection [43]. There are several generations of the robot with older generation units best suited for an operation in a single work field, with cumbersome redocking steps to perform multi-quadrant operations. The majority of studies indicate a longer operating time secondary to robot set up and draping. Technically speaking, the robot does not provide haptic feedback challenging the surgeon to "feel with their eyes" and occasionally resulting in excessive tissue damage in inexperienced hands. Further studies are needed to examine the comparative effectiveness of robotic versus laparoscopic minimally invasive hepatectomy.

**Figure 5.** Standard operating room set up for robotic-assisted liver surgery. Head of bed is on left side of image,

**Figure 4.** Image of port placement for a robot-assisted surgeries left lateral sectionectomy. Blue dots denote da Vinci 8-mm reusable cannulas (3). Green dot denotes 12-mm camera port. Purple dot denotes AirSeal® assistant port. Costal

margin and midline marked in dotted pen.

68 Liver Cancer

anesthesia equipment and personnel on right side of image.
