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Robotic Liver Resection With Scope Transition Technique: A Single-Center Experience
Hayato Baba1, Yosuke Inoue1, Kosuke Kobayashi1
1Division of Hepatobiliary and Pancreatic Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan.
Asian Journal of Endoscopic Surgery
|January 6, 2026
Summary
Scope transition improves visualization during robotic liver resection (RLR). This technique enhances surgical feasibility without increasing complications, making RLR safer and more effective.
Area of Science:
- Minimally Invasive Surgery
- Surgical Technology
- Hepatobiliary Surgery
Background:
- Robotic liver resection (RLR) offers expanding clinical utility but faces visualization challenges due to rigid endoscopes.
- Optimizing the surgical field is crucial for successful RLR outcomes.
Purpose of the Study:
- To evaluate the effectiveness of the scope-transition technique in enhancing surgical field visualization during RLR.
- To assess the safety and feasibility of implementing scope transition in RLR procedures.
Main Methods:
- Retrospective analysis of 73 RLR patients (Oct 2022-Sep 2024) utilizing standardized port configurations.
- Scope transition involved relocating the endoscope to an alternate port to improve visualization when needed.
- Parenchymal transection primarily used clamp-crushing with the Pringle maneuver, supplemented by CUSA for extensive planes.
Main Results:
- Scope transition was performed 41 times in 23 patients (32%), mainly for visualization of transection planes (56%) and liver mobilization (29%).
- Median transition duration was 80 seconds; no intraoperative complications or conversions to open surgery were recorded.
- Median operative time was 211 minutes, median blood loss 40 mL, with 10% experiencing Clavien-Dindo grade II complications. All resections achieved R0 status.
Conclusions:
- Scope transition is a safe and effective strategy to improve visualization during robotic liver resection.
- This technique enhances surgical feasibility in RLR, contributing to successful outcomes.
