Advancements in Minimally Invasive and Robotic Surgery for Hepatobiliary and Pancreatic Procedures

A large single‑center series (n>200) reports oncologic efficacy and low morbidity after minimally invasive radical cholecystectomy for gallbladder cancer, with negligible port‑site recurrence in the cohort. The institutional experience supports favorable short‑ and mid‑term oncologic outcomes alongside low perioperative physiologic impact in carefully selected patients, though findings reflect a single high‑volume center and may not be immediately generalizable.

This retrospective, single‑unit analysis includes 222 patients treated between 2011 and 2023, with 205 confirmed malignancies analyzed for oncologic outcomes. Key endpoints: median overall survival 60 months (95% CI 41–62); 3‑ and 5‑year survival 62.3% and 42.9%, respectively; mean operative time ~232 ± 55.3 minutes; mean blood loss ~153.8 ± 68.4 mL. The cohort included primary and selected locally advanced (T3/T4) tumors, with a low conversion frequency and no observed port‑site recurrences in the reported series.

Robotic platforms, advanced laparoscopic techniques and intraoperative imaging were used to mitigate the technical demands of radical cholecystectomy. The team reports routine use of complex hilar lymphadenectomy and formal liver‑bed resection, supported by intraoperative ultrasound and image‑guided planning to optimize margins and limit blood loss. Augmented‑reality overlays and 3D preoperative reconstructions are described as practical aids rather than prescriptive steps.

The low conversion rate likely reflects selective referral patterns and concentrated team experience. Together with modest blood loss and acceptable operative durations, this suggests a mature institutional pathway—multidisciplinary coordination, iterative technique refinement and structured perioperative care—drove outcomes more than a single transferable technique.

In sum, the single‑unit data indicate that minimally invasive radical cholecystectomy can achieve oncologic adequacy in selected patients when performed in experienced centers with appropriate technical adjuncts. Multicenter validation is needed to define broader adoption, training requirements and referral frameworks.

Key Takeaways:

• The series reports median survival of 60 months and no port‑site recurrences among 205 malignant cases, supporting oncologic adequacy of minimally invasive radical cholecystectomy in this cohort.
• Technical adjuncts—robotics, advanced laparoscopy, intraoperative ultrasound and 3D planning—are described as facilitative elements that correlate with low blood loss and acceptable operative times.
• Low conversion rates and modest perioperative morbidity likely reflect center experience and case selection, limiting immediate generalizability.
• Multicenter replication, formalized training pathways, and careful patient selection are needed to evaluate broader adoption.