Robotic liver resection: technique and results of 30 consecutive procedures
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Robotic surgery can enhance a surgeon’s laparoscopic skills through a magnified three-dimensional view and instruments with seven degrees of freedom compared to conventional laparoscopy.
This study reviewed a single surgeon’s experience of robotic liver resections in 30 consecutive patients, focusing on major hepatectomy. Clinicopathological characteristics and perioperative and short-term outcomes were analyzed.
The mean age of the patients was 52.4 years and 14 were male. There were 21 malignant tumors and 9 benign lesions. There were 6 right hepatectomies, 14 left hepatectomies, 4 left lateral sectionectomies, 2 segmentectomies, and 4 wedge resections. The average operating time for the right and left hepatectomies was 724 min (range 648–812) and 518 min (range 315–763), respectively. The average estimated blood loss in the right and left hepatectomies was 629 ml (range 100–1500) and 328 ml (range 150–900), respectively. Four patients (14.8%) received perioperative transfusion. There were two conversions to open surgery (one right hepatectomy and one left hepatectomy). The overall complication rate was 43.3% (grade I, 5; grade II, 2; grade III, 6; grade IV, 0) and 40% in 20 patients who underwent major hepatectomy. Among the six (20.0%) grade III complications, a liver resection–related complication (bile leakage) occurred in two patients. The mean length of hospital stay was 11.7 days (range 5–46). There was no recurrence in the 13 patients with hepatocellular carcinoma during the median follow-up of 11 months (range 5–29).
From our experience, robotic liver resection seems to be a feasible and safe procedure, even for major hepatectomy. Robotic surgery can be considered a new advanced option for minimally invasive liver surgery.
KeywordsRobotic liver resection Major hepatectomy Technique Short-term outcomes
The authors thank Mr. Dong-Su Jang, Research Assistant, Department of Anatomy, Yonsei University College of Medicine, Seoul, Korea, for his help with the figures. This study was supported by a faculty research grant from the Yonsei University College of Medicine for 2008 (6-2008-0128).
Gi Hong Choi, Sung Hoon Choi, Sung Hoon Kim, Ho Kyoung Hwang, Chang Moo Kang, Jin Sub Choi, and Woo Jung Lee have no conflicts of interest to disclose.
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