{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T17:57:22Z","timestamp":1781719042429,"version":"3.54.5"},"reference-count":39,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2025,12,22]],"date-time":"2025-12-22T00:00:00Z","timestamp":1766361600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Robot-assisted procedures represent a significant advancement in minimally invasive liver resection techniques. Nonetheless, the introduction of a novel surgical technique in a new environment necessitates meticulous planning and a gradual, stepwise approach. This study describes the adoption of a robotic surgical platform for liver resection at a high-volume tertiary care center. Materials and Methods: We retrospectively analyzed data that had been prospectively collected from fifty robot-assisted liver resections. Descriptive statistics, including frequencies, percentages, means\/medians, and standard deviations, were employed for description and summary. Results: The median operative duration was 166 min (range: 85\u2013400 min), with an average intraoperative blood loss of 200 mL (range: 50\u20131000 milliliters). Intraoperative or postoperative blood transfusion was required in 8% of patients. Conversion to open resection was necessary in one patient (2%). The mean duration of hospitalization was 5 days (range: 3\u201320 days), with a 30-day readmission rate of 6% and no mortality within 90 days. Postoperative complications classified as Clavien-Dindo grade 3 or higher were observed in five patients (10%). The mean tumor size varied according to pathology: 58.5 mm (range: 30\u2013120 mm) in the hepatocellular carcinoma group; 27.4 mm (range: 10\u201332 mm) in the secondary malignancy group; and 42.6 mm (range: 24\u201360 mm) in the intrahepatic cholangiocarcinoma group. The median number of lymph nodes harvested during lymphadenectomy (IHHCA\/GBCA) was 5.4, ranging from 1 to 11. The R0 resection rate for malignant tumors was 88.2% (of 30\/34). Conclusions: This study validates the safe integration of robot-assisted surgery into liver disease treatment, supported by our initial experience. Despite its technical advantages, robotic-assisted liver surgery remains complex and demanding. Structured robotic training within established programs, meticulous patient selection, and a stepwise implementation approach are critical during the early phases to optimize the outcomes.<\/jats:p>","DOI":"10.3390\/medicina62010018","type":"journal-article","created":{"date-parts":[[2025,12,22]],"date-time":"2025-12-22T11:43:31Z","timestamp":1766403811000},"page":"18","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Establishing a Robot-Assisted Liver Surgery Program: Early Experience from University Medical Center Ljubljana"],"prefix":"10.3390","volume":"62","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1002-4853","authenticated-orcid":false,"given":"Miha","family":"Petri\u010d","sequence":"first","affiliation":[{"name":"Department of Abdominal Surgery, University Medical Center Ljubljana, Zaloska 7, 1000 Ljubljana, Slovenia"},{"name":"Faculty of Medicine, University of Ljubljana, Korytkova 2, 1000 Ljubljana, Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"\u017diva","family":"Nardin","sequence":"additional","affiliation":[{"name":"Faculty of Medicine, University of Ljubljana, Korytkova 2, 1000 Ljubljana, Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9832-4596","authenticated-orcid":false,"given":"Jan","family":"Grosek","sequence":"additional","affiliation":[{"name":"Department of Abdominal Surgery, University Medical Center Ljubljana, Zaloska 7, 1000 Ljubljana, Slovenia"},{"name":"Faculty of Medicine, University of Ljubljana, Korytkova 2, 1000 Ljubljana, Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1063-8636","authenticated-orcid":false,"given":"Ale\u0161","family":"Toma\u017ei\u010d","sequence":"additional","affiliation":[{"name":"Department of Abdominal Surgery, University Medical Center Ljubljana, Zaloska 7, 1000 Ljubljana, Slovenia"},{"name":"Faculty of Medicine, University of Ljubljana, Korytkova 2, 1000 Ljubljana, Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bo\u0161tjan","family":"Ple\u0161nik","sequence":"additional","affiliation":[{"name":"Department of Abdominal Surgery, University Medical Center Ljubljana, Zaloska 7, 1000 Ljubljana, Slovenia"},{"name":"Faculty of Medicine, University of Ljubljana, Korytkova 2, 1000 Ljubljana, Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bla\u017e","family":"Trotov\u0161ek","sequence":"additional","affiliation":[{"name":"Department of Abdominal Surgery, University Medical Center Ljubljana, Zaloska 7, 1000 Ljubljana, Slovenia"},{"name":"Faculty of Medicine, University of Ljubljana, Korytkova 2, 1000 Ljubljana, Slovenia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,12,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"777","DOI":"10.1001\/archsurg.138.7.777","article-title":"Robotics in general surgery: Personal experience in a large community hospital","volume":"138","author":"Giulianotti","year":"2003","journal-title":"Arch. 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