International Benchmark Values for Robotic Right Hepatectomy: Multicenter Study From 22 Expert Centers

Philip C Müller; Noa L E Aegerter; Adrian T Billeter; Janina Eden; Beat Moeckli; Charles Chung-Wei Lin; Yuta Abe; Yutaka Nakano; Roberta Odorizzi; Mafalda Sobral; Florian Primavesi; Stefan Stättner; Ricardo Robles-Campos; Victor Lopez-Lopez; Cristiano Guidetti; Fabrizio Di Benedetto; Schaima Abdelhadi; Christoph Reissfelder; Raphael L C Araujo; John B Martinie; Riccardo Memeo; Antonella Delvecchio; Christoph Tschuor; Daisuke Fukumori; Mathieu D'Hondt; Taiga Wakabayashi; Go Wakabayashi; Andrea Lauterio; Leonardo Centonze; Gi Hong Choi; Gabriela Pilz da Cunha; Rutger-Jan Swijnenburg; Philipp von Kroge; Asmus Heumann; Shadi Katou; Benjamin Struecker; Andreas Pascher; Zhihao Li; Mohammed Abu Hilal; Soufyan El Adel; Simon Störzer; Moritz Schmelzle; Juba Ait Mohand; Mickaël Lesurtel; Sarkis Drejian; Åsmund Avdem Fretland; Bjørn Edwin; Michael Ginesini; Ugo Boggi; Gianluca Rompianesi; Roberto Ivan Troisi; Mirhasan Rahimli; Roland Croner; Christian Toso; Tomoaki Kato; Jason Hawksworth; Hugo Pinto Marques; Iswanto Sucandy; Philipp Dutkowski; Christoph Kuemmerli; Beat P Müller

doi:10.1097/AS9.0000000000000625

International Benchmark Values for Robotic Right Hepatectomy: Multicenter Study From 22 Expert Centers

Philip C Müller, Noa L E Aegerter, Adrian T Billeter, Janina Eden, Beat Moeckli, Charles Chung-Wei Lin, Yuta Abe, Yutaka Nakano, Roberta Odorizzi, Mafalda Sobral, Florian Primavesi, Stefan Stättner, Ricardo Robles-Campos, Victor Lopez-Lopez, Cristiano Guidetti, Fabrizio Di Benedetto, Schaima Abdelhadi, Christoph Reissfelder, Raphael L C Araujo, John B MartinieRiccardo Memeo, Antonella Delvecchio, Christoph Tschuor, Daisuke Fukumori, Mathieu D'Hondt, Taiga Wakabayashi, Go Wakabayashi, Andrea Lauterio, Leonardo Centonze, Gi Hong Choi, Gabriela Pilz da Cunha, Rutger-Jan Swijnenburg, Philipp von Kroge, Asmus Heumann, Shadi Katou, Benjamin Struecker, Andreas Pascher, Zhihao Li, Mohammed Abu Hilal, Soufyan El Adel, Simon Störzer, Moritz Schmelzle, Juba Ait Mohand, Mickaël Lesurtel, Sarkis Drejian, Åsmund Avdem Fretland, Bjørn Edwin, Michael Ginesini, Ugo Boggi, Gianluca Rompianesi, Roberto Ivan Troisi, Mirhasan Rahimli, Roland Croner, Christian Toso, Tomoaki Kato, Jason Hawksworth, Hugo Pinto Marques, Iswanto Sucandy, Philipp Dutkowski, Christoph Kuemmerli, Beat P Müller

Afdeling for Transplantation og Sygdomme i Fordøjelsessystemet CKO

Abstract

OBJECTIVE: This study aimed to identify benchmark values for robotic right hepatectomy (RH) based on a low-risk cohort treated at expert centers.

BACKGROUND: Robotic liver surgery is emerging as a preferred minimally invasive approach to the liver. To enable conclusive comparisons with the standard open or laparoscopic approaches, reference values are needed.

METHODS: Outcomes from consecutive patients undergoing robotic RH for malignant or benign indications at 22 international expert centers between 2018 and 2024 were analyzed. Low-risk, benchmark patients were without significant comorbidities such as portal hypertension, Child B cirrhosis, cardiac disease, chronic pulmonary disease, and renal failure. Patients undergoing robotic RH for donor hepatectomy were excluded. Fifteen reference values were derived from the 75th or the 25th percentile of the median values of all centers. Reference values were compared with a laparoscopic cohort from 4 centers and published benchmark values for laparoscopic and open RH.

RESULTS: Of 357 patients, 172 (48%) qualified as the benchmark cohort. The main indications were hepatocellular carcinoma (31%) and colorectal liver metastases (27%). Reference values included: operative time (≤476 min), conversion rate (≤8.2%), bile leak (≤15.4%), major complications (≤23.1%), and comprehensive complication index at 90 days (≤15.6). Robotic RH compared favorably to a multinational cohort series of laparoscopic RH with lower conversion (10.0% vs ≤8.2%) and R1 rate (10.9% vs ≤0%). Compared to open robotic hepatectomy, cutoffs for major complications (≤50.0% vs ≤23.1%) and liver failure (≤22.0% vs ≤2.7%) were lower for robotic right hepatectomies.

CONCLUSION: This international benchmark study on robotic right hepatectomy (RRH) demonstrates that the robotic approach provides advantages compared with laparoscopic and open RH. RRH can be expected to become the minimally invasive approach of choice for tumors in the right liver.

Originalsprog	Engelsk
Tidsskrift	Annals of surgery open : perspectives of surgical history, education, and clinical approaches
Vol/bind	6
Udgave nummer	4
Sider (fra-til)	e625
ISSN	2691-3593
DOI	https://doi.org/10.1097/AS9.0000000000000625
Status	Udgivet - dec. 2025

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10.1097/AS9.0000000000000625Licens: CC BY-NC-ND

Citationsformater

Müller, P. C., Aegerter, N. L. E., Billeter, A. T., Eden, J., Moeckli, B., Lin, C. C.-W., Abe, Y., Nakano, Y., Odorizzi, R., Sobral, M., Primavesi, F., Stättner, S., Robles-Campos, R., Lopez-Lopez, V., Guidetti, C., Di Benedetto, F., Abdelhadi, S., Reissfelder, C., Araujo, R. L. C., ... Müller, B. P. (2025). International Benchmark Values for Robotic Right Hepatectomy: Multicenter Study From 22 Expert Centers. Annals of surgery open : perspectives of surgical history, education, and clinical approaches, 6(4), e625. https://doi.org/10.1097/AS9.0000000000000625

International Benchmark Values for Robotic Right Hepatectomy: Multicenter Study From 22 Expert Centers. / Müller, Philip C; Aegerter, Noa L E; Billeter, Adrian T et al.
I: Annals of surgery open : perspectives of surgical history, education, and clinical approaches, Bind 6, Nr. 4, 12.2025, s. e625.

Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › peer review

Müller, PC, Aegerter, NLE, Billeter, AT, Eden, J, Moeckli, B, Lin, CC-W, Abe, Y, Nakano, Y, Odorizzi, R, Sobral, M, Primavesi, F, Stättner, S, Robles-Campos, R, Lopez-Lopez, V, Guidetti, C, Di Benedetto, F, Abdelhadi, S, Reissfelder, C, Araujo, RLC, Martinie, JB, Memeo, R, Delvecchio, A, Tschuor, C , Fukumori, D, D'Hondt, M, Wakabayashi, T, Wakabayashi, G, Lauterio, A, Centonze, L, Choi, GH, Pilz da Cunha, G, Swijnenburg, R-J, von Kroge, P, Heumann, A, Katou, S, Struecker, B, Pascher, A, Li, Z, Abu Hilal, M, El Adel, S, Störzer, S, Schmelzle, M, Mohand, JA, Lesurtel, M, Drejian, S, Fretland, ÅA, Edwin, B, Ginesini, M, Boggi, U, Rompianesi, G, Troisi, RI, Rahimli, M, Croner, R, Toso, C, Kato, T, Hawksworth, J, Marques, HP, Sucandy, I, Dutkowski, P, Kuemmerli, C & Müller, BP 2025, 'International Benchmark Values for Robotic Right Hepatectomy: Multicenter Study From 22 Expert Centers', Annals of surgery open : perspectives of surgical history, education, and clinical approaches, bind 6, nr. 4, s. e625. https://doi.org/10.1097/AS9.0000000000000625

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title = "International Benchmark Values for Robotic Right Hepatectomy: Multicenter Study From 22 Expert Centers",

abstract = "OBJECTIVE: This study aimed to identify benchmark values for robotic right hepatectomy (RH) based on a low-risk cohort treated at expert centers.BACKGROUND: Robotic liver surgery is emerging as a preferred minimally invasive approach to the liver. To enable conclusive comparisons with the standard open or laparoscopic approaches, reference values are needed.METHODS: Outcomes from consecutive patients undergoing robotic RH for malignant or benign indications at 22 international expert centers between 2018 and 2024 were analyzed. Low-risk, benchmark patients were without significant comorbidities such as portal hypertension, Child B cirrhosis, cardiac disease, chronic pulmonary disease, and renal failure. Patients undergoing robotic RH for donor hepatectomy were excluded. Fifteen reference values were derived from the 75th or the 25th percentile of the median values of all centers. Reference values were compared with a laparoscopic cohort from 4 centers and published benchmark values for laparoscopic and open RH.RESULTS: Of 357 patients, 172 (48%) qualified as the benchmark cohort. The main indications were hepatocellular carcinoma (31%) and colorectal liver metastases (27%). Reference values included: operative time (≤476 min), conversion rate (≤8.2%), bile leak (≤15.4%), major complications (≤23.1%), and comprehensive complication index at 90 days (≤15.6). Robotic RH compared favorably to a multinational cohort series of laparoscopic RH with lower conversion (10.0% vs ≤8.2%) and R1 rate (10.9% vs ≤0%). Compared to open robotic hepatectomy, cutoffs for major complications (≤50.0% vs ≤23.1%) and liver failure (≤22.0% vs ≤2.7%) were lower for robotic right hepatectomies.CONCLUSION: This international benchmark study on robotic right hepatectomy (RRH) demonstrates that the robotic approach provides advantages compared with laparoscopic and open RH. RRH can be expected to become the minimally invasive approach of choice for tumors in the right liver.",

author = "M{\"u}ller, {Philip C} and Aegerter, {Noa L E} and Billeter, {Adrian T} and Janina Eden and Beat Moeckli and Lin, {Charles Chung-Wei} and Yuta Abe and Yutaka Nakano and Roberta Odorizzi and Mafalda Sobral and Florian Primavesi and Stefan St{\"a}ttner and Ricardo Robles-Campos and Victor Lopez-Lopez and Cristiano Guidetti and {Di Benedetto}, Fabrizio and Schaima Abdelhadi and Christoph Reissfelder and Araujo, {Raphael L C} and Martinie, {John B} and Riccardo Memeo and Antonella Delvecchio and Christoph Tschuor and Daisuke Fukumori and Mathieu D'Hondt and Taiga Wakabayashi and Go Wakabayashi and Andrea Lauterio and Leonardo Centonze and Choi, {Gi Hong} and {Pilz da Cunha}, Gabriela and Rutger-Jan Swijnenburg and {von Kroge}, Philipp and Asmus Heumann and Shadi Katou and Benjamin Struecker and Andreas Pascher and Zhihao Li and {Abu Hilal}, Mohammed and {El Adel}, Soufyan and Simon St{\"o}rzer and Moritz Schmelzle and Mohand, {Juba Ait} and Micka{\"e}l Lesurtel and Sarkis Drejian and Fretland, {{\AA}smund Avdem} and Bj{\o}rn Edwin and Michael Ginesini and Ugo Boggi and Gianluca Rompianesi and Troisi, {Roberto Ivan} and Mirhasan Rahimli and Roland Croner and Christian Toso and Tomoaki Kato and Jason Hawksworth and Marques, {Hugo Pinto} and Iswanto Sucandy and Philipp Dutkowski and Christoph Kuemmerli and M{\"u}ller, {Beat P}",

note = "Copyright {\textcopyright} 2025 The Author(s). Published by Wolters Kluwer Health, Inc.",

year = "2025",

month = dec,

doi = "10.1097/AS9.0000000000000625",

language = "English",

volume = "6",

pages = "e625",

journal = "Annals of surgery open : perspectives of surgical history, education, and clinical approaches",

issn = "2691-3593",

number = "4",

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TY - JOUR

T1 - International Benchmark Values for Robotic Right Hepatectomy

T2 - Multicenter Study From 22 Expert Centers

AU - Müller, Philip C

AU - Aegerter, Noa L E

AU - Billeter, Adrian T

AU - Eden, Janina

AU - Moeckli, Beat

AU - Lin, Charles Chung-Wei

AU - Abe, Yuta

AU - Nakano, Yutaka

AU - Odorizzi, Roberta

AU - Sobral, Mafalda

AU - Primavesi, Florian

AU - Stättner, Stefan

AU - Robles-Campos, Ricardo

AU - Lopez-Lopez, Victor

AU - Guidetti, Cristiano

AU - Di Benedetto, Fabrizio

AU - Abdelhadi, Schaima

AU - Reissfelder, Christoph

AU - Araujo, Raphael L C

AU - Martinie, John B

AU - Memeo, Riccardo

AU - Delvecchio, Antonella

AU - Tschuor, Christoph

AU - Fukumori, Daisuke

AU - D'Hondt, Mathieu

AU - Wakabayashi, Taiga

AU - Wakabayashi, Go

AU - Lauterio, Andrea

AU - Centonze, Leonardo

AU - Choi, Gi Hong

AU - Pilz da Cunha, Gabriela

AU - Swijnenburg, Rutger-Jan

AU - von Kroge, Philipp

AU - Heumann, Asmus

AU - Katou, Shadi

AU - Struecker, Benjamin

AU - Pascher, Andreas

AU - Li, Zhihao

AU - Abu Hilal, Mohammed

AU - El Adel, Soufyan

AU - Störzer, Simon

AU - Schmelzle, Moritz

AU - Mohand, Juba Ait

AU - Lesurtel, Mickaël

AU - Drejian, Sarkis

AU - Fretland, Åsmund Avdem

AU - Edwin, Bjørn

AU - Ginesini, Michael

AU - Boggi, Ugo

AU - Rompianesi, Gianluca

AU - Troisi, Roberto Ivan

AU - Rahimli, Mirhasan

AU - Croner, Roland

AU - Toso, Christian

AU - Kato, Tomoaki

AU - Hawksworth, Jason

AU - Marques, Hugo Pinto

AU - Sucandy, Iswanto

AU - Dutkowski, Philipp

AU - Kuemmerli, Christoph

AU - Müller, Beat P

PY - 2025/12

Y1 - 2025/12

N2 - OBJECTIVE: This study aimed to identify benchmark values for robotic right hepatectomy (RH) based on a low-risk cohort treated at expert centers.BACKGROUND: Robotic liver surgery is emerging as a preferred minimally invasive approach to the liver. To enable conclusive comparisons with the standard open or laparoscopic approaches, reference values are needed.METHODS: Outcomes from consecutive patients undergoing robotic RH for malignant or benign indications at 22 international expert centers between 2018 and 2024 were analyzed. Low-risk, benchmark patients were without significant comorbidities such as portal hypertension, Child B cirrhosis, cardiac disease, chronic pulmonary disease, and renal failure. Patients undergoing robotic RH for donor hepatectomy were excluded. Fifteen reference values were derived from the 75th or the 25th percentile of the median values of all centers. Reference values were compared with a laparoscopic cohort from 4 centers and published benchmark values for laparoscopic and open RH.RESULTS: Of 357 patients, 172 (48%) qualified as the benchmark cohort. The main indications were hepatocellular carcinoma (31%) and colorectal liver metastases (27%). Reference values included: operative time (≤476 min), conversion rate (≤8.2%), bile leak (≤15.4%), major complications (≤23.1%), and comprehensive complication index at 90 days (≤15.6). Robotic RH compared favorably to a multinational cohort series of laparoscopic RH with lower conversion (10.0% vs ≤8.2%) and R1 rate (10.9% vs ≤0%). Compared to open robotic hepatectomy, cutoffs for major complications (≤50.0% vs ≤23.1%) and liver failure (≤22.0% vs ≤2.7%) were lower for robotic right hepatectomies.CONCLUSION: This international benchmark study on robotic right hepatectomy (RRH) demonstrates that the robotic approach provides advantages compared with laparoscopic and open RH. RRH can be expected to become the minimally invasive approach of choice for tumors in the right liver.

AB - OBJECTIVE: This study aimed to identify benchmark values for robotic right hepatectomy (RH) based on a low-risk cohort treated at expert centers.BACKGROUND: Robotic liver surgery is emerging as a preferred minimally invasive approach to the liver. To enable conclusive comparisons with the standard open or laparoscopic approaches, reference values are needed.METHODS: Outcomes from consecutive patients undergoing robotic RH for malignant or benign indications at 22 international expert centers between 2018 and 2024 were analyzed. Low-risk, benchmark patients were without significant comorbidities such as portal hypertension, Child B cirrhosis, cardiac disease, chronic pulmonary disease, and renal failure. Patients undergoing robotic RH for donor hepatectomy were excluded. Fifteen reference values were derived from the 75th or the 25th percentile of the median values of all centers. Reference values were compared with a laparoscopic cohort from 4 centers and published benchmark values for laparoscopic and open RH.RESULTS: Of 357 patients, 172 (48%) qualified as the benchmark cohort. The main indications were hepatocellular carcinoma (31%) and colorectal liver metastases (27%). Reference values included: operative time (≤476 min), conversion rate (≤8.2%), bile leak (≤15.4%), major complications (≤23.1%), and comprehensive complication index at 90 days (≤15.6). Robotic RH compared favorably to a multinational cohort series of laparoscopic RH with lower conversion (10.0% vs ≤8.2%) and R1 rate (10.9% vs ≤0%). Compared to open robotic hepatectomy, cutoffs for major complications (≤50.0% vs ≤23.1%) and liver failure (≤22.0% vs ≤2.7%) were lower for robotic right hepatectomies.CONCLUSION: This international benchmark study on robotic right hepatectomy (RRH) demonstrates that the robotic approach provides advantages compared with laparoscopic and open RH. RRH can be expected to become the minimally invasive approach of choice for tumors in the right liver.

U2 - 10.1097/AS9.0000000000000625

DO - 10.1097/AS9.0000000000000625

M3 - Journal article

C2 - 41451175

SN - 2691-3593

VL - 6

SP - e625

JO - Annals of surgery open : perspectives of surgical history, education, and clinical approaches

JF - Annals of surgery open : perspectives of surgical history, education, and clinical approaches

IS - 4

ER -

International Benchmark Values for Robotic Right Hepatectomy: Multicenter Study From 22 Expert Centers

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