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Major robotic hepatectomies: technical considerations

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Abstract

Robotic approach to the liver may allow to perform difficult resections with a minimally invasive strategy in an easier way as compared to standard laparoscopy. The aim of this study is to review our experience with robotic major hepatectomies, reporting technical considerations, and describing the outcomes of patients that underwent either left (LRH) or right robotic hepatectomy (RRH). Our prospectively maintained database was screened to identify all patients that received a major liver resection for benign or malignant disease. Preoperative data and postoperative short-term and long-term outcomes were reported. 261 robotic procedures were performed in our Center between May 2014 and October 2020. 12 patients underwent robotic left hepatectomy (RLH) and 10 patients were treated by robotic right hepatectomy (RRH). In the RLH group, median operative time (OT) was 383 min, median estimated blood loss (EBL) was 300 ml, and median in-hospital stay was of 3 days. In the RRH group, median OT was 490 min, median EBL 725 ml, and median hospital stay was 5 days. Although one of the advantages of minimally invasive surgery is to obtain radical resections with parenchyma sparing strategies, patients that need a major hepatectomy may benefit of a robotic resection with good postoperative outcomes. Team learning curve and growth instead of personal progression is crucial to expand the limits of novel surgical techniques.

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Authors and Affiliations

  1. Hepato-Pancreato-Biliary Surgery and Liver Transplantation Unit, University of Modena and Reggio Emilia, 41124, Modena, Italy

    Paolo Magistri, Giacomo Assirati, Roberto Ballarin, Stefano Di Sandro & Fabrizio Di Benedetto

Authors
  1. Paolo Magistri
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  2. Giacomo Assirati
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  3. Roberto Ballarin
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  4. Stefano Di Sandro
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  5. Fabrizio Di Benedetto
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Contributions

FDB: Study concept and design, supervision, critical review and final validation. PM: Study design, data analysis, manuscript drafting, and final validation. SDS: Study design, data analysis, manuscript drafting and final validation. GA: data collection, literature review, critical review and final validation. RB: supervision, literature review, critical review and final validation.

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Correspondence to Fabrizio Di Benedetto.

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The authors have no conflict of interest to disclose.

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The study was conducted according to the declaration of Helsinki, and the data collection was approved by the Institutional Review Board.

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Patients involved in the study signed a consent for data collection and diffusion.

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Magistri, P., Assirati, G., Ballarin, R. et al. Major robotic hepatectomies: technical considerations. Updates Surg 73, 989–997 (2021). https://doi.org/10.1007/s13304-020-00940-1

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  • DOI: https://doi.org/10.1007/s13304-020-00940-1

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