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We aimed to investigate the diffusion, indications, and short-term outcomes of MILS compared to the open approach.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>A prospective registry of all liver resections performed for any indication and using any technique between January 1, 2017, and December 31, 2019, was established (BReLLS) and analyzed.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>A total of 1342 consecutive liver resections were included, 684 (51%) MILS and 658 (49%) open procedures. MILS was not attempted due to technical complexity in the 46.2% of cases, followed by previous abdominal surgery (22.5%). Patients undergoing MILS had a higher proportion of benign indications and of hepatocellular carcinomas, patients affected by liver cirrhosis with portal hypertension and a lower proportion of major hepatectomies (all <jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001). After propensity-score matching, MILS showed better results in terms of surgery duration (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), blood loss (<jats:italic>p<\/jats:italic>\u2009=\u20090.015), complication rate (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), rate of Clavien-Dindo grade\u2009\u2265\u20093 complications (<jats:italic>p<\/jats:italic>\u2009=\u20090.012), comprehensive complication index (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), length of stay (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), readmissions (<jats:italic>p<\/jats:italic>\u2009=\u20090.016). Centers performing over 50 liver resections per year had a higher proportion of overall MILS cases (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), a similar proportion of major resections (<jats:italic>p<\/jats:italic>\u2009=\u20090.362), but a higher prevalence of MILS major resections (<jats:italic>p<\/jats:italic>\u2009=\u20090.004), lower 90-day mortality rates (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), lower overall complication rates (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001), and shorter hospital length of stay (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>MILS was the preferred technique in half of the cases, particularly in patients with cirrhosis and portal hypertension, and benign lesions. It provided superior short-term outcomes compared to the open approach for both minor and major liver resections in selected patients.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s00423-025-03661-4","type":"journal-article","created":{"date-parts":[[2025,3,3]],"date-time":"2025-03-03T05:32:37Z","timestamp":1740979957000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Multicenter Belgian prospective registry on minimally invasive and open liver surgery (BReLLS): experience from 1342 consecutive cases"],"prefix":"10.1007","volume":"410","author":[{"given":"Roberto Ivan","family":"Troisi","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gianluca","family":"Rompianesi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mathieu","family":"D\u2019Hondt","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aude","family":"Vanlander","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claude","family":"Bertrand","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Catherine","family":"Hubert","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Olivier","family":"Detry","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bert","family":"Van den Bossche","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philippe","family":"Malvaux","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph","family":"Weerts","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thibault","family":"Sablon","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Koen","family":"Vermeiren","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mehrdad","family":"Biglari","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Filip","family":"Gryspeerdt","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Celine","family":"De Meyere","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexandra","family":"Dili","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kim","family":"Boterbergh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Valerio","family":"Lucidi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,3,3]]},"reference":[{"issue":"3","key":"3661_CR1","doi-asserted-by":"publisher","first-page":"125","DOI":"10.1007\/s10353-018-0536-y","volume":"50","author":"M Fodor","year":"2018","unstructured":"Fodor M, Primavesi F, Braunwarth E, Cardini B, Resch T, Bale R et al (2018) Indications for liver surgery in benign tumours. 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