Related Experiment Video
Updated: Aug 8, 2026
09:19
Robotic Taj Mahal Hepatectomy for Hilar Cholangiocarcinoma
Published on: July 14, 2022
Robotic parenchyma-sparing resection with a multiplanar-driven approach: the mini-rollercoaster hepatectomy
Fabio Procopio1,2, Luca Risi1, Guido Costa1,2
1Department of Biomedical Sciences, Humanitas University, via Rita Levi Montalcini 4, 20072 , Pieve Emanuele, Milan, Italy.
Updates in Surgery
|August 7, 2026
Summary
Robotic multiplanar dissection, a "rollercoaster hepatectomy," offers a feasible parenchyma-sparing liver resection for tumors near hepatic veins. This minimally invasive approach ensures oncological safety and successful outcomes.
Area of Science:
- Hepatobiliary Surgery
- Minimally Invasive Surgical Oncology
- Robotic Surgery
Background:
- Anatomical plane dissection is standard for liver tumors near hepatic veins (HV) in minimally invasive surgery.
- The
Purpose of the Study:
- To explore the feasibility of robotic multiplanar-guided resection for liver metastases.
- To evaluate a parenchyma-sparing transversal hepatectomy approach.
Main Methods:
- Preoperative 3D rendering for surgical planning and vascular assessment.
- Intraoperative ultrasound (IOUS) guidance during parenchymal transection.
- Robotic resection using clamp-crushing technique and SynchroSeal device.
Main Results:
- Successful robotic R0 limited resection of segment 2 crossing the left hepatic vein (LHV).
- Procedure duration: 235 minutes with 30 minutes Pringle maneuver.
- Minimal blood loss and uneventful postoperative recovery with a 6-day hospital stay.
Conclusions:
- Robotic multiplanar dissection shows potential for transversal hepatectomy in liver surgery.
- This parenchyma-sparing approach may be suitable for selected liver metastases.
- Further research is needed to establish feasibility and reproducibility in complex cases.
