The robotic-assisted left lateral hepatic segmentectomy: the next step

Area of Science:

• Minimally invasive surgery
• Robotic surgery
• Hepatic surgery

Background:

• Minimally invasive surgery has advanced significantly, enabling complex hepatic interventions.
• Robotic-assisted surgery provides new possibilities for hepatectomies.
• Left lateral hepatic segmentectomy is a foundational procedure for learning hepatic resections.

Purpose of the Study:

• To demonstrate the feasibility of robotic-assisted left lateral hepatic lobectomy using the Da Vinci S system.
• To leverage the anatomical characteristics of the left lobe and robotic system's technical advantages.

Main Methods:

• Robotic-assisted left lateral lobectomy performed using a Da Vinci S system with three arms.
• Two additional laparoscopic ports were used for assistant surgeons.
• Procedure conducted by a surgeon experienced in hepatic and laparoscopic surgery, new to robotic techniques.

Main Results:

• Lobectomies were safely completed with an average operative time of 140 minutes.
• Minimal blood loss was observed, without the need for the Pringle maneuver.
• No conversions to open surgery or reoperations were required.

Conclusions:

• Robotic-assisted left lateral hepatic lobectomy is a feasible surgical technique.
• The procedure has the potential to decrease surgical trauma and patient pain.
• Robotic assistance may enhance surgeon's technical comfort during hepatic resections.