International consensus statement on robotic hepatectomy surgery in 2018

Table 1 2018 International statement on robotic hepatectomy

	Recommendation	Grade
1	RH is as safe and feasible as traditional OH. RH has longer operative time, less intraoperative blood loss, LOS, lower complication rate and lower severe complication rate. The intraoperative blood loss of RH is comparable to that of OH.	2C
2	RH has similar effectiveness for liver malignancy lesion compared to OH. Regarding the oncological outcome there is no significant difference in the radical resection rate, overall survival rate and recurrence rate between RH and OH.	2D
3	As a minimally invasive surgery, RH is as safe and feasible as traditional LH. RH has longer operative time, more intraoperative blood loss, and higher cost. RH has similar overall complication rate and LOS compared to OH. Conversion rate of RH would decrease with the experience accumulation.	2D
4	As minimally invasive surgery, RH has similar effectiveness for liver malignancy disease compared to LH. Regarding the oncological outcome there is no significant difference in the radical resection rate, overall survival rate and recurrence rate between RH and LH.	2D
5	For minor hepatectomy, RH as safe and feasible as LH and OH. RH has longer operative time than LH for minor hepatectomy. The intraoperative blood loss, overall postoperative complication rate and overall cost of robotic minor hepatectomy are comparable to that of laparoscopic minor hepatectomy.	2D
6	For major hepatectomy, RH as safe and feasible as LH and OH. RH has longer operative time than LH for major hepatectomy. The intraoperative blood loss, overall postoperative complication rate and overall cost of robotic major hepatectomy are comparable to that of laparoscopic major hepatectomy. There is no significant difference in the operative time, intraoperative blood loss and complication rate between RH and OH for minor hepatectomy.	2D
7	Robotic liver donor hepatectomy could be an alternative. The procedure should only be performed by experienced surgeons, and the true benefits of robotic donor hepatectomy need further investigation in the future.	2D

RH: Robotic hepatectomy; OH: Open hepatectomy; LH: Laparoscopic hepatectomy; LOS: Length of hospital stay.