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Updates in Surgery

, Volume 67, Issue 2, pp 177–183 | Cite as

Laparoscopic robot-assisted resection of tumors located in posterosuperior liver segments

  • Ugo Boggi
  • Fabio Caniglia
  • Fabio Vistoli
  • Francesca Costa
  • Erika Pieroni
  • Vittorio Grazio Perrone
Original Article
Part of the following topical collections:
  1. Minimally Invasive Liver Surgery: An Update

Abstract

Laparoscopic resection of liver tumors located in the posterosuperior segments is a challenging operation that could be facilitated by robotic assistance. Laparoscopic resection of 12 tumors located in posterosuperior segments (IVa: 1; VII: 5; VIII: 6) was carried out under robotic assistance. All patients had a single tumor nodule. Data were collected prospectively and analyzed retrospectively. Surgery required a mean of 260.4 min (115–430) and was completed laparoscopically in all but one patient, who required conversion to mini-laparotomy because of intolerance of pneumoperitoneum (8.3 %). Mean estimated blood loss was 252.7 ml (50–600), making transfusion necessary in 3 patients (25.0 %). Post-operative complications occurred in 4 patients (33.3 %), being of Clavien–Dindo grade II in 3 patients (25.0 %) and Clavien–Dindo grade IV in 1 patient (8.3 %). Reoperation was required in 1 patient, who subsequently had a long hospital stay, because of decompensated cirrhosis. Median length of hospital stay was 8.5 days (7–96). No patient was readmitted. Pathology showed hepatocellular carcinoma in 7 patients (58.3 %), liver metastasis in 2 patients (16.6 %), and hepatic adenoma, focal nodular hyperplasia, and hemangioma in one patient each (8.3 %). All patients had a margin negative resection. After a mean follow-up period of 21.4 months (±24.4), no patient with malignant histology developed recurrence. Our initial experience confirms that laparoscopic robot-assisted resection of tumors located in the posterosuperior segments is feasible. Further experience is needed before final conclusions can be drawn and meaningful comparison with other surgical techniques becomes possible.

Keywords

Robot da Vinci Liver Posterosuperior segments Segmentectomy Sub-segmentectomy 

Notes

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Standard

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Research involving human participants or animals

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent

Patients were extensively counseled about their disease, the operation that was planned, and the use of robotic assistance. All patients signed an informed consent.

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Copyright information

© Italian Society of Surgery (SIC) 2015

Authors and Affiliations

  • Ugo Boggi
    • 1
    • 2
  • Fabio Caniglia
    • 1
  • Fabio Vistoli
    • 1
  • Francesca Costa
    • 1
  • Erika Pieroni
    • 1
  • Vittorio Grazio Perrone
    • 1
  1. 1.Division of General and Transplant SurgeryUniversity of PisaPisaItaly
  2. 2.Azienda Ospedaliera Universitaria PisanaUniversità di PisaPisaItaly

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