Robotic Radical Surgery for Incidental Gallbladder Cancer is on the Rise

Robotic hepatobiliary surgery has been reported to improve surgeon ergonomics, surgical accuracy due to 3-D visualization, and increased range of motion. This approach facilitates extended hilar lymphadenectomy by identifying and controlling individual structures from the hepatoduodenal ligament. However, as with open surgery, there are some limitations to this approach in terms of anatomic segment-based liver resections.
Unlike open surgery, the minimally invasive complexity for completion radical cholecystectomy relies on prior dissection of the hepatic hilum, which may hinder precise dissection and adequate lymphadenectomy, as well as the need to remove segments 4b and 5. In this situation, the robotic platform may be useful. Recently, we also described the use of the Glissonian approach for robotic liver resection. The use of the Glissonian approach is useful in patients with previous manipulation of the hepatic hilum and in patients requiring anatomic bisegmentectomy 4b and 5.
In conclusion, the robotic approach is safe and feasible for radical surgery for incidental gallbladder cancer. The number of cases using the robotic platform is rapidly increasing.