First Report of Robotic-Assisted Liver Resection With Pre-Coagulation Technique by Microwave (With Video).

Area of Science:

• Minimally Invasive Surgery
• Surgical Oncology
• Hepatobiliary Surgery

Background:

• Robotic assistance enhances spatial cognition and manipulation for 3D liver resection.
• Controlling bleeding in cirrhotic livers during laparoscopic hepatectomy remains a challenge.
• Microwave pre-coagulation is presented as a novel technique for hemostasis.

Purpose of the Study:

• To report the first instance of robotic-assisted liver resection utilizing microwave pre-coagulation.
• To evaluate the efficacy of microwave pre-coagulation in managing bleeding during hepatectomy.
• To demonstrate the safety and feasibility of this combined approach.

Main Methods:

• A 71-year-old male with hepatocellular carcinoma in segment 3 of a cirrhotic liver underwent robotic resection.
• Microwave pre-coagulation was applied to the resection margin after tumor localization via ultrasound.
• Liver parenchyma dissection was performed using a double bipolar technique under Pringle's maneuver.

Main Results:

• The procedure involved microwave pre-coagulation followed by robotic dissection.
• The operation time was 248 minutes with a blood loss of 100 mL.
• The patient was discharged on postoperative day six with no complications.

Conclusions:

• Microwave pre-coagulation is a potentially valuable method for bleeding control in robotic hepatectomy.
• This technique is particularly relevant for cases with anticipated difficult hemostasis or during the introduction of robotic surgery.
• Further adoption of this method can enhance safety in complex liver resections.