Robot-assisted laparoscopic hemi-hepatectomy: Technique and surgical outcomes

Department of Surgery, Pamela Youde Nethersole Eastern Hospital, 3 Lok Man Road, Chai Wan, Hong Kong SAR, China.
International Journal of Surgery (London, England) (Impact Factor: 1.53). 11/2011; 10(1):11-5. DOI: 10.1016/j.ijsu.2011.10.005
Source: PubMed


Laparoscopic major hepatectomies remain a challenge for liver surgeons. The recent introduction of robotic surgical systems has revolutionized the field of minimally invasive surgery. It was developed to overcome the disadvantages of conventional laparoscopic surgery. The use of robotic system in laparoscopic major hepatectomy was not known yet.
Between December 2010 and July 2011, 6 right hemi-hepatectomies and 4 left hemi-hepatectomies were performed by robot-assisted laparoscopic approach. Prospectively collected data was analyzed retrospectively.
Overall mean duration of the operation was 347.4 ± 85.9 (SD) minutes. Mean duration of the operation for right hemi-hepatectomy was 364.8 ± 98.1 ml, while mean duration of the operation for left hemi-hepatectomy was 321.3 ± 67.8 ml. Overall mean operative blood loss was 407 ± 286.8 ml. Mean operative blood loss for right hemi-hepatectomy was 500 ± 303.3 ml, while mean operative blood loss for left hemi-hepatectomy was 156.9 ± 40.7 ml. No open conversion was needed. Three patients (30%) had postoperative complications. There was no mortality. Mean hospital stay was 6.7 ± 3.5 days.
Our series indicate that in experienced hands, robot-assisted laparoscopic approach for hemi-hepatectomy is feasible and safe. As experience grows, this procedure will be more common.

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    • "Mean intraoperative blood loss ranged from 50 to 660 mL. There was a tendency for patients to experience more blood loss during hepatectomies or combined colorectal surgeries [12, 15, 17]. No difference in blood loss was noted between robotic and laparoscopic surgeries in the series reported by Berber et al., whereas in the study by Ji et al. less blood loss was reported during robotic procedures than during laparoscopic and open resection procedures. "
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