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Three-Device (3D) Technique for Liver Parenchyma Dissection in Robotic Liver Surgery
Aristotelis Perrakis1, Mirhasan Rahimli1, Andrew A Gumbs2
1University Clinic for General, Visceral, Vascular and Transplant Surgery, University of Magdeburg, Leipzigerstr. 44, 39120 Magdeburg, Germany.
Journal of Clinical Medicine
|November 27, 2021
Summary
This study introduces a novel 3D technique for robotic liver surgery parenchyma dissection, improving vessel control and safety. The method is safe and feasible, advancing robotic hepatectomy standardization.
Area of Science:
- Hepatobiliary Surgery
- Minimally Invasive Surgery
- Surgical Robotics
Background:
- Robotic liver surgery offers enhanced dexterity over conventional methods.
- Parenchymal transection is a challenging aspect of robotic liver resection due to instrument limitations.
- A novel strategy for robotic liver parenchyma dissection was developed and evaluated.
Purpose of the Study:
- To present and evaluate a new three-dimensional (3D) technique for liver parenchyma transection during robotic surgery.
- To assess the safety and feasibility of this novel approach in both minor and major liver resections.
Main Methods:
- A novel 3D technique using monopolar scissors, bipolar Maryland forceps, and a laparoscopic-guided waterjet was employed.
- Perioperative data from 28 patients undergoing robotic liver resection between February 2019 and December 2020 were collected.
- The Magdeburg Registry of minimally invasive liver surgery (MD-MILS) was utilized for data collection.
Main Results:
- Twenty-eight patients (12 major, 16 minor hepatectomies) underwent the 3D parenchyma dissection.
- R0 resection was achieved in all malignant cases.
- Liver surgery-related morbidity was 10.7% with no mortalities.
Conclusions:
- The 3D parenchyma dissection technique is safe and feasible for robotic liver surgery.
- This method allows for precise preparation of intrahepatic vessels and bile ducts.
- The technique represents a significant advancement towards standardizing robotic hepatectomy for routine care and training.
