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Robotic biliary surgery for benign and malignant bile duct obstruction: a case series

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Abstract

The majority of patients with benign or malignant biliary obstruction require surgical treatment with a bilio-enteric anastomosis. This requires fine dissection and advanced suturing. Robotic surgery may overcome some major limitations of conventional laparoscopic surgery. The precise role of robotic biliary surgery is, however, still to be defined. In our institution, patients requiring complex bile duct surgery were consecutively selected for minimally invasive robotic surgery from September 2020. All surgeries were undertaken using the da Vinci Xi Surgical System® (Intuitive Surgical, Sunnyvale, CA, USA). Intra-operative technique and postoperative outcome were analyzed. A total number of 14 patients underwent robotic biliary surgery for a variety of benign and malignant indications between September 2020 and May 2021. Six of fourteen patients (43%) had previous open abdominal surgery. Median blood loss was 25 mL (range 10–120 mL). There were no intra-operative complications and no conversions. Length of stay was between 3 and 11 days without major postoperative morbidity. Robotic surgery for benign and malignant bile duct obstruction is efficient and safe in experienced hands. Referral to a high-volume expert center is, however, advised.

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Funding

Dr. Mathieu D’Hondt and Dr. Dennis Wicherts declare that no funds, grants, or other support were received during the preparation of this manuscript.

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Authors and Affiliations

  1. Department of Digestive and Hepatobiliary/Pancreatic Surgery, Groeninge Hospital, President Kennedylaan 4, 8500, Kortrijk, Belgium

    Mathieu D’Hondt

  2. Department of Abdominal and Hepatobiliary/Pancreatic Surgery, Ziekenhuis Oost-Limburg, Schiepse Bos 6, 3600, Genk, Belgium

    Dennis A. Wicherts

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  1. Mathieu D’Hondt
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  2. Dennis A. Wicherts
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by MD and DW. The first draft of the manuscript was written by MD and Dr. DW and both authors commented on previous versions of the manuscript. Both authors read and approved the final manuscript.

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Correspondence to Mathieu D’Hondt.

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Dr. Mathieu D’Hondt and Dr. Dennis Wicherts have no relevant financial or non-financial interests to disclose.

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D’Hondt, M., Wicherts, D.A. Robotic biliary surgery for benign and malignant bile duct obstruction: a case series. J Robotic Surg 17, 55–62 (2023). https://doi.org/10.1007/s11701-022-01392-y

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  • DOI: https://doi.org/10.1007/s11701-022-01392-y

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