Abstract:Background and Aims The robot-assisted laparoscopic hepatectomy (RALH) can overcome some technical limitations in traditional laparoscopic hepatectomy (LH), and also improve the operating flexibility and accuracy. However, results of previous Meta-analysis created controversial consequences on whether RALH is indeed superior to LH. Therefore, this study was performed to reevaluate the efficacy and safety of RALH for the treatment of liver tumors by a new Meta-analysis.Methods Both Chinese and English literature of all studies comparing RALH and LH in the treatment of liver tumors were collected by searching several national and international databases. The retrieval time was set from January 2000 to February 2021. After literature screening and quality assessment, Meta-analysis was performed by using the RevMan5.3 software.Results A total of 30 studies were included, involving 3 480 patients, with 1 332 cases in RALH group and 2 148 cases in LH group. Results of Meta-analysis showed that in RALH group compared with LH group, the operative time was longer (MD=45.66, 95% CI=26.60-64.72, P<0.000 01), intraoperative conversion rate was lower (RR=0.66, 95% CI=0.50-0.86, P=0.002), intraoperative blood transfusion rate was higher (RR=1.88, 95% CI=1.30-2.71, P=0.000 7) and total cost was higher (MD=0.51, 95% CI=0.44-0.57, P<0.000 01). However, there were no significant differences in terms of the intraoperative blood loss, hepatic portal occlusion rate, incidence of postoperative complications, length of postoperative hospital stay, mortality, and the R0 and R1 resection rates (all P>0.05).Conclusion Based on the current evidence, RALH is safe and effective. Although it has higher total cost and longer operative duration, there is almost no difference with LH in other main outcome indicators, suggesting that they have similar surgical efficacy and safety, and more clinical randomized controlled trials are still needed for verification in the future.