Robotic isolated partial and complete hepatic caudate lobectomy: A single institution experience

Area of Science:

• Hepatobiliary Surgery
• Minimally Invasive Surgery
• Robotic Surgery

Background:

• Robotic hepatic caudate lobectomy reports are limited, primarily focusing on Spiegel lobectomy.
• This study evaluates the safety and feasibility of robotic isolated partial and complete hepatic caudate lobectomy.

Purpose of the Study:

• To compare the safety and feasibility of robotic isolated partial and complete hepatic caudate lobectomy.
• To analyze perioperative outcomes across different types of robotic caudate lobectomy.

Main Methods:

• Retrospective analysis of 32 patients undergoing robotic hepatic caudate lobe resection (May 2016 - January 2020).
• Patients categorized into three groups: left dorsal segment (Spiegel) lobectomy, right dorsal segment (caudate process/paracaval) lobectomy, and complete caudate lobectomy.
• Comparison of general information and perioperative results among the three groups.

Main Results:

• No conversions to laparotomy, minimal intraoperative transfusion (9.38%), and no severe complications (Clavien-Dindo grade III+) or perioperative deaths.
• Left dorsal segment lobectomy showed significantly shorter operative times and less blood loss compared to right dorsal segment and complete caudate lobectomy.
• Postoperative hospital stay was significantly shorter for left dorsal segment lobectomy compared to complete caudate lobectomy.

Conclusions:

• Robotic isolated partial and complete caudate lobectomy demonstrate safety and feasibility.
• Spiegel lobectomy is a relatively straightforward procedure, recommended for novice robotic hepatic surgeons.