Robotic hepatectomy in IWATE expert-level liver resections results in less blood loss and a shorter hospital stay compared to open surgery, without increasing major complications or mortality.

• In a matched cohort of 68 patients, robotic surgery had a median operative time of 240 minutes versus 206 minutes for open surgery (p = 0.002), lower estimated blood loss (100 ml vs. 200 ml; p = 0.038), and shorter postoperative stay (6 days vs. 9 days; p < 0.001).
• Major complications occurred in 13.2% of robotic cases compared to 19.1% for open cases (p = 0.480), with no significant differences in 90-day mortality.

These findings suggest that robotic techniques may offer logistical benefits in skilled hands for complex liver resections without compromising patient safety.