Initial Experience with a Robotic Hepatectomy Program at a High-volume Laparoscopic Center: Single-center Experience and Surgical Tips

Overview

Journal Ann Transl Med

Publisher AME Publishing Company

Date 2021 Aug 25

PMID 34430573

Citations 3

Authors

Boram Lee

YoungRok Choi

Jai Young Cho

Yoo-Seok Yoon

Ho-Seong Han

Affiliations

Soon will be listed here.

Abstract

Background: Despite the development of laparoscopic surgery, there are still inherent limitations associated with conventional laparoscopic instruments such as restrictions in movement and an inability for articulation. Robotic surgery may help to overcome the limitations of conventional laparoscopic surgery. The aim of this study was to present our initial experience with robotic hepatectomy (RH) and discuss the steps required to develop an RH program at a high-volume laparoscopic hepatectomy (LH) center.

Methods: We retrospectively reviewed prospectively collected data for 14 consecutive patients who underwent RH between 2017 and 2018. Clinicopathological characteristics and perioperative outcomes were compared with those reported in previous studies. The operation time of each procedure was analyzed to assess RH proficiency based on experience.

Results: Of the 14 patients, 12 patients (85.7%) underwent robotic major hepatectomy. Median patient age was 54.5 years, while median body mass index (BMI) was 25.2 kg/m. The median operation time was 360 (range: 145-544) min. The median estimated blood loss (EBL) was 300 (range: 50-1,400) mL. Conversion to open surgery was not required in any case. The median length of hospital stay was 5 (range: 4-14) days. Major complications occurred in 2 patients (14.2%), although both recovered without sequelae. The time required for hilar dissection, docking, and parenchymal transection gradually decreased after the first two cases of RH.

Conclusions: From our initial experience, RH might be considered as a feasible procedure in the liver resection, even in major hepatectomy. In addition, surgeons with sufficient experience in LH could rapidly adapt for RH. However, we have to make a system for education and monitoring of this innovative surgery for the patients' safety.

Citing Articles

The method of using robotic Harmonic ACE curved shears for parenchymal transection in robotic hepatectomy.

Jang E, Kang S, Kim K J Minim Invasive Surg. 2024; 27(2):114-117.

PMID: 38887003 PMC: 11187608. DOI: 10.7602/jmis.2024.27.2.114.

Exploring the feasibility of robotic liver resection in a limited resource setting.

Jang E, Kang S, Kim K J Robot Surg. 2024; 18(1):187.

PMID: 38683380 DOI: 10.1007/s11701-024-01901-1.

Short-term outcomes of robotic liver resection: An initial single-institution experience.

Duran M, Briceno J, Padial A, Anelli F, Sanchez-Hidalgo J, Ayllon M World J Hepatol. 2022; 14(1):224-233.

PMID: 35126850 PMC: 8790404. DOI: 10.4254/wjh.v14.i1.224.

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