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Updated: Sep 4, 2026

Robotic Left Hepatectomy using Indocyanine Green Fluorescence Imaging for an Intrahepatic Complex Biliary Cyst
Published on: June 24, 2022
Minimally Invasive Hepatobiliary and Pancreatic Surgery
Faiz Gani1, Nolan M Winicki2, Kelly J Lafaro3
1Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Abstract:
Minimally invasive surgery has transformed hepatobiliary and pancreatic (HPB) care, yet adoption remains slower than in other fields due to patient selection, learning curves, costs, and training gaps. This article reviews robotic-assisted HPB procedures, focusing on liver resections and pancreaticoduodenectomy, and outlines indications, preoperative workup, positioning, and steps. Robotic liver resection offers advantages in 3 dimensional visualization, ergonomics, and instrument dexterity, though it lacks tactile feedback. A preoperative computed tomography assessment and future liver remnant calculation guide patient selection. Intraoperative indocyanine green fluorescence, vascular control, and standardized teams support safe implementation, with PD discussed regarding benefits and cost considerations today.