Dorsal Stable Surgical Procedure for the Glissonean Approach in Robot Anatomic Liver Resections of the Left Lateral...

Laparoscopic left lateral sectionectomy (LLLS) is often performed as an introduction to laparoscopic liver resection (LLR). However, laparoscopic anatomical liver resection (LALR) of the left lateral segment is a challenging procedure. There are few reports on LALR of the left lateral segment. Robot liver resection (RLR) has the benefits of a stable blur-free visual field and mobility with multi-joint forceps, so robot anatomical liver resection (RALR) of the left lateral segment can be carried out safely.

LLR and RLR were retrospectively investigated from January 2017 to August 2024. The procedure of RALR of the left lateral segment was demonstrated, and the safety of RALR of the left lateral segment was evaluated by comparing the perioperative outcomes to LLR.

This study comprised 13 LLLS cases, 5 LALR cases, and 10 RALR cases. In LLR, it was more likely that LLLS was performed for the lesion of Segment 2 (11 cases) and LALR was performed for the lesion of Segment 3 (4 cases). LALR had a significantly longer operation time than LLLS. On the other hand, the difference in operation time between RALR and LLLS was not statistically significant. The amount of blood loss was not significantly different between LLLS and RALR. Other perioperative outcomes, such as length of stay or postoperative complications, did not show any differences.

RALR of the left lateral segment is regarded as a safe approach in the treatment of liver tumors.