Related Experiment Video
Updated: Aug 7, 2026
Modified Laparoscopic Anatomic Hepatectomy: Two-Surgeon Technique Combined with the Simple Extracorporeal Pringle Maneuver
Published on: June 16, 2023
Console surgeon-controlled suction and coagulation during robot-assisted hepatectomy: early clinical evaluation of
Yoshito Tomimaru1, Kiyokazu Nakajima1,2, Naoto Gotohda3
1Department of Gastroenterological Surgery, Graduate School of Medicine, The University of Osaka, Osaka, Japan.
Background:
We recently developed a novel flexible suction/coagulation probe to overcome the rigidity of conventional electrosurgical probes, enabling simultaneous suction and coagulation from the console in robotic surgery. Although feasible in robot-assisted gastrectomy, its performance remains unevaluated in robot-assisted hepatectomy, which requires frequent suction and reliable hemostasis.
Methods:
This single-arm feasibility study included 12 consecutive patients undergoing robot-assisted hepatectomy using the probe, directly manipulated by the console surgeon for hemostasis during parenchymal transection. Surgical outcomes (operative time, estimated blood loss, device trouble, complications) were assessed. Surgeons completed a post-procedure questionnaire covering seven usability and performance domains on a 3-point Likert scale.
Results:
Robotic procedures included left hepatectomy, segmentectomies, and partial resections. All procedures were completed successfully without conversion. Median operative time was 397.5 min (range, 256-678 min), and estimated blood loss was 110 mL (range, 0-320 mL). No device-related adverse events or complications occurred. Overall satisfaction was rated 'satisfactory' by 75% of surgeons, with 'unsatisfactory' ratings occurring only for suction efficiency (16.7%).
Conclusions:
The flexible suction/coagulation probe appears to be a practical and clinically feasible option for robot-assisted hepatectomy. Although the suction efficiency requires further improvement, the device enables direct console surgeon-controlled suction and hemostasis during hepatic parenchymal transection.
