Related Experiment Video
Updated: Feb 26, 2026
11:03
Robotic Left Hepatectomy using Indocyanine Green Fluorescence Imaging for an Intrahepatic Complex Biliary Cyst
Published on: June 24, 2022
6.3K
Robotic left lateral sectionectomy as stepwise approach for cirrhotic liver
Raphael L C Araujo1, Luís Antônio de Castro2, Fernando E C Fellipe3
1Department of Upper Gastrointestinal and Hepato-pancreato-biliary Surgery, Barretos Cancer Hospital, Rua Antenor Duarte Villela, 1331, Barretos, SP, CEP 14784-400, Brazil. raphael.l.c.araujo@gmail.com.
Journal of Robotic Surgery
|July 23, 2017
Summary
Robotic left lateral sectionectomy (LLS) is a feasible approach for cirrhotic patients with compensated liver function. This minimally invasive technique offers potential benefits comparable to laparoscopic surgery, even during a robotic learning curve.
Area of Science:
- Hepatobiliary Surgery
- Minimally Invasive Surgery
- Robotic Surgery
Background:
- Laparoscopic left lateral sectionectomy (LLS) is the standard for liver resection.
- Laparoscopic surgery reduces bleeding and morbidity in cirrhotic patients compared to open surgery.
- Robotic liver resection is feasible but underreported in cirrhotic patients.
Observation:
- Two cases of cirrhotic men (HCV and alcoholic) underwent robotic LLS for left lobe lesions.
- Procedures utilized intraoperative ultrasound and linear staplers, with specimen extraction via Pfannenstiel incision.
- Both patients had compensated liver function (MELD 9-10, Child-Pugh A5-A6).
Findings:
- Robotic LLS was performed without Pringle maneuver, with operative times of 250 and 151 minutes and blood loss of 100 and 70 ml.
- Postoperative recovery was uneventful, with discharge on postoperative days 3 and 4.
- Pathology confirmed hepatocellular carcinoma (2.5 cm and 4.5 cm) with negative margins and underlying cirrhosis.
Implications:
- Robotic LLS is a feasible stepwise procedure for surgeons on a robotic learning curve.
- Selected cirrhotic patients may benefit from robotic liver resection.
- This approach may offer advantages similar to laparoscopic surgery for specific liver resections.
