Evidence map›Paper›PMID 42811178›Full record

ArticleSurgical endoscopy2026

Robotic versus laparoscopic anatomical hepatectomy: a post hoc analysis of the ROC'N'ROLL randomized controlled trial.

Emrullah Birgin, Marie Heibel, Svetlana Hetjens, Erik Rasbach, Christoph Reissfelder, Patrick Téoule, Nuh N Rahbari

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Article in Surgical endoscopy, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Emrullah BirginDepartment of General and Visceral Surgery, Ulm University Hospital, Ulm, Germany. emrullah.birgin@uniklinik-ulm.de.
Marie HeibelDepartment of Surgery, Medical Faculty Mannheim, Universitätsmedizin Mannheim, Heidelberg University, Mannheim, Germany.
Svetlana HetjensDepartment of Medical Statistics and Biomathematics, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
Erik RasbachDepartment of Surgery, Medical Faculty Mannheim, Universitätsmedizin Mannheim, Heidelberg University, Mannheim, Germany.
Christoph ReissfelderDepartment of Surgery, Medical Faculty Mannheim, Universitätsmedizin Mannheim, Heidelberg University, Mannheim, Germany.
Patrick TéouleDepartment of Surgery, Medical Faculty Mannheim, Universitätsmedizin Mannheim, Heidelberg University, Mannheim, Germany.
Nuh N RahbariDepartment of General and Visceral Surgery, Ulm University Hospital, Ulm, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundRobotic liver surgery may overcome technical limitations of laparoscopic approaches, particularly for anatomical hepatectomy. Comparative prospective data remain limited.

methodsThis exploratory post hoc analysis of the ROC'N'ROLL randomized controlled trial included patients scheduled for minimally invasive anatomical hepatectomy before randomization. Participants were randomized to robotic (RAH) or laparoscopic anatomical hepatectomy (LAH). The primary endpoint of this analysis was the rate of severe postoperative complications (Clavien-Dindo grade ≥ III) within 90 days. No subgroup-specific sample size calculation was performed. Secondary outcomes included conversion, operative time, blood loss, oncological outcomes, recovery, and patient-reported outcomes (PROs).

resultsAmong 81 randomized participants, 57 were scheduled for anatomical hepatectomy (RAH, n = 30; LAH, n = 27). Baseline imbalances were present, with larger tumors in the RAH group (median, 59 vs 40 mm; P = 0.048) and higher IWATE difficulty scores (median, 10 vs 7; P = 0.029). Operating time was longer with RAH (median, 252 vs 190 min; P = 0.021). Severe complications occurred in 13% after RAH and 37% after LAH (odds ratio, 0.27; 95% CI, 0.07-0.97; P = 0.045). No clear between-group differences were observed in conversion, blood loss, length of stay, functional recovery, margin status, mortality, or PROs.

conclusionsRobotic anatomical hepatectomy was associated with fewer severe complications despite higher procedural complexity. These exploratory findings support its use in high-difficulty cases but require prospective validation. (DRKS00027531).

Indexed as

Anatomical hepatectomyLiver malignanciesMinimally invasive liver surgeryRobotic surgeryROC’N’ROLL trial

Identifiers

PMID42811178

What Socratic holds

Textmetadata
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.