This leaflet answers common questions about minimally invasive robotic liver, pancreas and biliary surgery. This leaflet will be provided alongside information about your specific surgery. If you would like further information, or have any worries, please do not hesitate to ask your nurse or doctor.

In all cases, a doctor will explain the procedure to you and answer any questions you may have.

What is minimally invasive robotic surgery?

Laparoscopic (keyhole) surgery, where only small incisions are made to the patient’s tummy and pelvis, has replaced many of open operations. However, when this type of surgery cannot be done due to technical challenges, minimally invasive robotic surgery can be used and can offer excellent outcomes. 

Using a surgical robot gives surgeons a greater control in a minimally invasive procedure and means they can safely perform more complex surgical procedures. 

How is it performed?

The surgery is performed using a surgical robot, which allows your surgeon to have a larger view of the inside of your tummy (abdomen). This makes it easier to see small and delicate structures around the liver, pancreas, spleen, gallbladder and bile ducts, and allows for more accuracy during the operation.  

Your surgeon will make a few tiny incisions on the abdomen and introduce a 3D-HD camera within the abdominal cavity and introduce gas in the abdomen to separate and visualise the organs. They will then insert further special robotic instruments in the abdominal cavity, attaching these on to the robotic arms to carry out the operation.

The surgeon fully controls the robot from a console located in the operating room. The robot mirrors a surgeon’s hands movements within the patient and cannot make any movement without the surgeon’s command.  

Who performs my surgery?

Your surgery is performed by a team of surgeons and theatre staff who are trained in the use of the robot. They have gone through a mentoring process and their results are closely audited to make sure patients are offered the best possible outcomes. 

Why is it being offered to me?

You are likely to benefit from the robotic surgery which is an extension of minimally invasive laparoscopic (keyhole) surgery.

We believe the robotic surgery will reduce your requirement for intensive care after surgery, will reduce your hospital stay and you will recover better and sooner from your operation while not compromising on the surgical outcomes.

Before your procedure

Other scans and procedures may be required to clarify your diagnosis and help decide on your best treatment options. We may need to repeat a scan you’ve already had or you may need some different ones and can include any of the following:

  • CT, MRI, or ultrasound scan
  • Nuclear medicine investigations, eg a PET scan
  • Endoscopic investigations, eg an ERCP (endoscopic retrograde cholangiopancreatography) and/or an EUS (endoscopic ultrasound)
  • Laparoscopy (keyhole surgery to view the abdominal organs)

Information is available on the scans and procedures so please ask a member of staff if you would like a leaflet or visit our website. Please do ask your healthcare team as many questions as you need to, as it is important that you fully understand all aspects of your operation.

You will also need to attend a pre-operative assessment, where a nurse will check you are fit enough to undergo the surgery. This may involve a telephone appointment and tests such as an electrocardiogram (tracing of the heart rhythm), blood tests and occasionally an x-ray. Some people may need to see an anaesthetist or have more complex tests. 

After your procedure

Recovery after surgery will depend on the type of surgery you have. Please refer to the main operation information leaflet for information about what to expect after surgery, which you can also discuss with your surgeon. 

Risks and side effects

The risks with minimally invasive robotic surgery are the same as those of conventional laparoscopic (keyhole) surgery which include the risk of damage to bowels, blood vessels and risk of conversion to open procedure.

Robot specific risk could be a slightly longer operating time in theatres, which is compensated for by a shorter overall hospital stay as the patients will recover sooner than conventional surgery.

Robotic surgery benefits

Minimally invasive robotic surgery allows surgeons to perform procedures which are too difficult or not possible using laparoscopic (keyhole) surgery. It is a way of performing major surgery without large incisions and reduces the need for you to stay in intensive care after surgery. Compared to open surgery, robotic surgery reduces the likelihood of pain, infection, scarring, or risk of incisional hernias.

Due to the small incisions made during the procedure, robotic surgery means you are less likely to experience wound-related complications and will experience less wound pain. You may also be able to return to normal life quicker and have a shorter hospital stay compared to an open procedure.

Robotic surgery alternatives

The alternative to minimally invasive robotic surgery is open surgery or, in some cases, non-robotic laparoscopic (keyhole) surgery. If you would like more information about this, please ask your consultant.