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Robotic Major Hepatectomy: An Institutional Experience and Clinical Outcomes

  • Peritoneal Surface Malignancy
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Abstract

Introduction

Most of the literature has only reported outcomes on robotic minor non-anatomical hepatectomy. This study was undertaken to analyze and examine the safety, feasibly, and perioperative outcomes of robotic major hepatectomy at our institution.

Methods

All patients undergoing robotic major hepatectomy were prospectively followed. Major hepatectomy was defined as a resection of 3 or more segments. Data are expressed as median (mean ± SD).

Results

A total of 170 consecutive patients underwent robotic hepatectomies, of which 100 were major resections involving at least 3 segments. The 100 patients were of median 62 (61 ± 13.0) years, and 46% were women. Median BMI was 29 (29 ± 5.9) kg/m2 and median ASA class was 3 (3 ± 0.5). Thirty percent of robotic major hepatectomies were for hepatocellular carcinoma, 28% were for metastatic adenocarcinoma, 9% were for cholangiocarcinoma, and 5% were for metastatic neuroendocrine tumor. Prep time (in the room until incision) was a median 58 min (62 ± 18.4), extraction time (incision until specimen extraction) was 124 min (146 ± 99.5), console time was 198 min (210 ± 123.9), closure time (extraction until dressing placement) was 109 min (131 ± 93.8), operative duration was 246 min (269 ± 123.2), and time under anesthesia was 330 min (353 ± 109.6). Estimated blood loss was 175 ml (249 ± 275.9) and length of stay was 4 days (5 ± 4.3). Seven patients experienced postoperative complications. Thirteen patients were readmitted within 30 days, and one patient died within 30 days.

Conclusion

Application of the robotic platform to major hepatectomy is safe and feasible. Our early experience shows that this minimally invasive approach results in excellent short-term outcomes.

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Authors and Affiliations

  1. AdventHealth Tampa, Digestive Health Institute, Tampa, FL, USA

    Iswanto Sucandy MD, FACS, Kenneth Luberice MD, Trenton Lippert BS, Miguel Castro BS, Emily Krill BS, Sharona Ross MD, FACS & Alexander Rosemurgy MD, FACS

Authors
  1. Iswanto Sucandy MD, FACS
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  2. Kenneth Luberice MD
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  3. Trenton Lippert BS
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  4. Miguel Castro BS
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  5. Emily Krill BS
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  6. Sharona Ross MD, FACS
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  7. Alexander Rosemurgy MD, FACS
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Contributions

Iswanto Sucandy, Alexander Rosemurgy, Sharona Ross: provided substantial contributions to the conception and design of the study. Kenneth Luberice, Trenton Lippert, Miguel Castro, and Emily Krill: provided substantial contributions in the manner of data acquisition, analysis, and interpretation of the data for the manuscript. All authors participated in drafting the manuscript and provided critical revisions for important intellectual content. All authors agree to be accountable for all aspects of the work and are confident of the integrity of the contributions of co-authors.

Corresponding author

Correspondence to Iswanto Sucandy MD, FACS.

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Disclosures

Authors Alexander Rosemurgy and Sharona Ross have educational and research relationships with Intuitive Surgical Inc. (Intuitive Corporation, Sunnyvale, CA). Kenneth Luberice, Trenton Lippert, Miguel Castro, Emily Krill, and Iswanto Sucandy have no disclosures/conflicts of interest.

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Sucandy, I., Luberice, K., Lippert, T. et al. Robotic Major Hepatectomy: An Institutional Experience and Clinical Outcomes. Ann Surg Oncol 27, 4970–4979 (2020). https://doi.org/10.1245/s10434-020-08845-4

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  • DOI: https://doi.org/10.1245/s10434-020-08845-4

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