Different Approaches in Robotic Liver Surgery: Console Surgeon And Bedside Surgeon (The RoboLap Approach)

In a recent European survey concerning the implementation of minimally invasive robotic and laparoscopic technologies in the field of liver surgery, it emerged that the most frequently used technique for parenchymal transection involves the combination of bipolar forceps (with the rationale of performing Kellyclasia) and monopolar scissors [1]. Interestingly, the majority of robotic liver surgeons declared themselves dissatisfied with the robotic instruments currently available for parenchymal transection, specifically complaining about the lack of an ultrasonic dissector [1]. In fact, laparoscopic ultrasonic-mediated parenchymal dissection is precise and effective: combined with the image magnification and the improvement in terms of spatial resolution provided by a mini-invasive approach, it allows effective reproduction of almost the whole portfolio of liver resections, thereby improving the feasibility and reproducibility of mini-invasiveness [2–4].