Robotic Central Bisectionectomy for Centrally Located Hepatic Malignant Tumor

Area of Science:

• Hepatobiliary Surgery
• Surgical Robotics
• Oncology

Background:

• Laparoscopic hepatectomies for central tumors are complex.
• Robotic liver surgery has limitations, making robotic central bisectionectomy rare.
• This article presents key techniques for robotic central bisectionectomy.

Purpose of the Study:

• To demonstrate useful technical tips for performing robotic central bisectionectomy.
• To highlight the application of specific maneuvers and technologies in robotic liver surgery.
• To provide guidance for surgeons undertaking complex robotic liver resections.

Main Methods:

• A case of robotic central bisectionectomy for hepatocellular carcinoma involving segments IV and VIII.
• Demonstration of resection line determination, traction methods, and robotic instrument use.
• Application of Pringle's maneuver and indocyanine-green fluorescence imaging.

Main Results:

• The procedure was completed in 320 minutes with 200 ml blood loss, no transfusion required.
• The patient had an uneventful recovery and was discharged on postoperative day seven.
• Pathological analysis confirmed hepatocellular carcinoma with a 1.5 cm surgical margin.

Conclusions:

• Robotic central bisectionectomy is a demanding procedure requiring specific technical expertise.
• Safe execution is achievable with proper exposure and a combination of technical tips.
• This approach provides a safe and effective option for complex liver resections.