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Robotic Right Posterior Sectionectomy by Intrafascial Approach for Pancreas Neuroendocrine Liver Metastasis
Jacques-Emmanuel Saadoun1, Charles Vanbrugghe1, Régis Fara1
1Department of Digestive Surgery, Hôpital Européen, 6 rue désirée Clary, 13003, Marseille, France.
Annals of Surgical Oncology
|March 23, 2023
Summary
Robotic surgery enables difficult minimally invasive liver resections for neuroendocrine tumor metastases. This approach enhances surgeon dexterity for posterior sectionectomies, improving patient recovery and outcomes.
Area of Science:
- Surgical Oncology
- Minimally Invasive Surgery
- Robotic Surgery
Background:
- Liver resection is crucial for resectable neuroendocrine tumor metastases.
- Minimally invasive techniques offer faster recovery but struggle with posterior liver access.
- Robotic surgery presents a potential solution to overcome laparoscopic limitations.
Observation:
- A 46-year-old patient with pancreatic neuroendocrine tumor and liver metastases underwent robotic distal pancreatectomy.
- Two months later, a robotic right posterior sectionectomy and segment 8 wedge resection were performed.
- The procedure utilized the Da Vinci X robot with a four-hands technique and intra-fascial approach.
Findings:
- Robotic posterior sectionectomy was feasible and safe, with controlled vascular and biliary structures.
- The surgery involved 330 minutes with minimal blood loss (50 ml).
- A grade B biliary fistula was the only postoperative complication, with discharge on day 10.
Implications:
- Robotic surgery enhances surgeon dexterity for complex liver resections.
- This approach expands the possibilities for minimally invasive treatment of liver metastases.
- It offers a promising alternative for challenging posterior liver resections in neuroendocrine tumors.
