Related Experiment Video
Updated: Dec 29, 2025
Robotic Taj Mahal Hepatectomy for Hilar Cholangiocarcinoma
Published on: July 14, 2022
Full robotic ALPPS for HCC with intrahepatic portal vein thrombosis
Fabrizio Di Benedetto1, Giacomo Assirati1, Paolo Magistri1
1Hepato-Pancreato-Biliary Surgery and Liver Transplantation Unit, University of Modena and Reggio Emilia, Modena, Italy.
Background:
The associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) technique can induce a greater degree of hypertrophy of the future liver remnant (FLR) in a shorter time compared with other procedures. A robotic approach may reduce the complication rate, increasing the ability to perform classic ALPPS.
Methods:
We report technical and clinical considerations on the first full robotic ALPPS (stages 1 and 2) for hepatocellular carcinoma (HCC) with portal vein intrahepatic tumor thrombus.
Results:
The patient was a 38-year-old man with Milan-out HCC and FLR volume of 19.6%. On postoperative day (POD) 8, FLR increased to 37%; therefore, he underwent completion of ALPPS on POD 10. The postoperative course was uneventful, and the patient was discharged in good general conditions on POD 3.
Conclusion:
Robotic ALPPS is safe and feasible for selected patients with initially unresectable HCC or requiring extended resections, with good postoperative outcomes.
