Removing or destroying liver tumors often requires patients to undergo two separate procedures, exposing them to multiple hospital stays, repeated anesthesia, and longer recovery times. Traditional approaches also rely on less precise techniques when CT imaging is not available in the operating room, limiting accuracy when tumors are hard to reach. Now, a new approach combines robotic liver resection and CT-guided ablation in a single operation to reduce patient burden and improve precision.

This combined procedure was developed and performed at Amsterdam UMC (Amsterdam, Netherlands), where teams integrated robotic surgery with CT-guided interventional oncology workflows inside a hybrid operating room. The method brings together two standard liver tumor treatments—robot-assisted resection and image-guided ablation—within one tightly coordinated surgical session. CT guidance allows real-time visualization of tumor targets during ablation, while robotic instruments support highly controlled liver resection.

During the procedure, surgeons removed tumor tissue robotically and then used CT imaging to guide heat-based ablation of additional lesions, ensuring complete coverage while preserving healthy liver tissue. This dual-modality approach reduces the need for large incisions and avoids staging the treatments separately. Initial use of the technique followed months of preparation, ensuring safe integration of surgical and interventional teams.

A clinical study is now underway at Amsterdam UMC to evaluate safety, feasibility, and early outcomes in 15 patients with liver tumors. The goal is to compare the single-session method with standard, separate procedures to determine its benefits in recovery time, complication rates, and overall effectiveness. Depending on the results, a larger multicenter trial involving additional UMCs is planned.

Performing both treatments at once can significantly reduce strain on patients by avoiding repeat anesthesia and hospital admissions, while advanced ablation technologies can improve precision. The researchers expect this new treatment will become accessible to all patients with liver tumors within three years.

"Until now, these procedures could only be done separately or with less precise techniques through a large incision in the abdomen or traditional laparoscopic surgery without a CT scanner,” said Rutger-Jan Swijnenburg, MD, liver surgeon at Amsterdam UMC and co-developer of the combined procedure. “The patient had to undergo two separate hospital stays and receive anesthesia twice. By performing both procedures within one operation, we minimize the burden on the patient."

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