Advanced Minimally Invasive Hepatopancreaticobiliary Surgery—Robotic and Laparoscopic Techniques

Minimally invasive hepatobiliary and pancreatic surgery is a field that is increasingly evolving and being used ever more frequently. The trend towards the increased use of these procedures is evident not only with regard to laparoscopy, but also in the field of robotics. Laparoscopy offers its well-known advantages: less blood loss, less trauma, and shorter hospital stays. Robotics boasts technical advantages: tremor filtration, motion scaling, and magnification. With regard to minimally invasive pancreatic surgery (with the exception of Whipple surgery), several studies have shown that not only the surgical results but also the oncological outcome are comparable to open surgery. Moreover, it can be performed safely; however, a high level of experience is a prerequisite of its safe performance. The same is true for hepatobiliary surgery. Similar results are reported for robot-assisted surgery. The technical features of these systems confer advantages particularly in the case of complex resections and reconstructions. Overall, the learning curve in minimally invasive surgical methods in hepatopancreatobiliary surgery is extremely flat. Well-structured training programs are essential in order to overcome this hurdle. The use of new technologies such as artificial intelligence can also help to make minimally invasive pancreatic and hepatobiliary surgery better and safer in the future. Last but not least, high-quality randomized controlled trials are needed to increase the evidence in this field. © 2021, Springer-Verlag GmbH Austria, ein Teil von Springer Nature.