The Future of Hepatic Surgery

**215**

**Chapter 11**

**Abstract**

**1. Introduction**

**2. Liver anatomy**

factors) and enzymes.

*and Aamir Z. Khan*

Robotic Liver Surgery

*Ricky Harminder Bhogal, Stephanos Pericleous*

**Keywords:** robotic surgery, liver surgery, liver metastasis,

minimally invasive surgery, liver resection

ogy, surgical techniques and patient outcomes.

Robotic liver surgery is an evolving specialty within liver surgery. The robotic platform allows some of the limitations in both open and laparoscopic surgery to be overcome. Indeed as the technology develops there is scope for the number of robotic liver resections to increase as well as their complexity. In this chapter we discuss the current robotic platform, review the current role of robotics in liver surgery and review the available data in the literature on patient outcome.

For many patients with liver tumours, whether benign or malignant, the optimal form of management is liver surgery. In the modern era with advancement anaesthetic techniques, improved understanding of liver pathophysiology and peri-operative patient management liver surgery has become a safe operation with excellent patient outcomes. Concomitant with this advancement in patient care has been a greater understanding of the nature of liver surgery and improving the precision of liver surgery. In particular surgery has followed the trend in other surgical disciplines and moved towards minimal access surgery. Building on the experiences of laparoscopic liver surgery hepatobiliary surgeons have begun to develop robotic liver surgical programs. Many institutes worldwide have performed complex liver procedures using robot-assisted surgery. This chapter summarises the nascent of field of robotic liver surgery and provides an overview of the current robot technol-

The liver is an accessory digestive gland located in the right upper quadrant of the abdomen. The liver's primary function is to produce bile that aids in the emulsification and digestion of dietary fat. The liver also serves many other critical functions including metabolism of drugs and toxins, removing degradation products of normal body metabolism and synthesis of many important proteins (e.g. clotting

The liver is anatomically divided into two major lobes or into eight segments. Cantile line, which runs from the inferior vena cava (IVC) to the gallbladder fossa, marks the division between the left and right hemi-livers. Each hemi-liver can be divided further anatomically; the left liver can be divided into a left lateral section
