Robotic Segmentectomy 8 Using a Cranio-Ventral Approach (With Video)

Vein-guided resection using the cranio-ventral approach (CVA) prevents split injuries during laparoscopic anatomical liver resection, but its utility in robot-assisted surgery remains unreported. A 74-year-old woman with hepatocellular carcinoma underwent robotic segmentectomy 8 using the da Vinci Xi system. We evaluated the safety and feasibility of robotic segmentectomy 8 using the CVA approach with port hopping. After caudal liver mobilization, port hopping enabled access to the roots of the middle hepatic vein and right hepatic vein, allowing parenchymal transection with the CVA. The operative time was 583 min with 30 mL blood loss. Recovery was uneventful with discharge on postoperative day 14. Robotic CVA with port hopping demonstrates feasibility for anatomical liver resection.