Robotic-Assisted Laparoscopic Anatomic Hepatectomy in China

Abstract

These preliminary results show that robotic-assisted laparoscopic anatomic hepatectomy is safe and feasible with a much lower complication and conversion rate than traditional laparoscopic hepatectomy or open resection. The robotic surgical system may broaden the indications for laparoscopic hepatactomy, and it enabled the surgeon to perform precise laparoscopic liver resection which required hylum dissection, hepatocaval dissection, endoscopic suturing, and microanastamosis. However, more long-term, evidence-based outcomes will be necessary to prove its efficacy, and further research on its cost-effectiveness is still required.

Robotic hepatobiliary and pancreatic surgery: a cohort study

“…No margin was positive. For patients with HCC, the mean surgical margin was 13 mm (range [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20], and for colorectal metastases, it was 25 mm (range 5-70) [16]. All these suggest that oncological efficacy can be achieved even in robotic liver resections.…”

“…Although Giulianotti et al [16] reported that major liver resections are associated with longer operating times (313 vs. 198 min, median) and more blood loss (300 vs. 150 mL, median) when compared with minor resections, there was no difference in mortalities and major morbidities. Anatomical hepatectomies were possible and feasible even in the more challenging posterior segments with the help of the robot [16,17]. Inevitably, it was associated with longer operating time but with similar or lowered blood loss when compared with the laparoscopic group or open group.…”

“…Giulianotti et al [16] reported 60% malignant conditions in his series of 70 robotic liver resections. Ji et al [17] also reported that around 60% of his 13 patients who underwent robotic liver resections had malignant tumours. One reason is that there is a higher prevalence of hepatitis B carrier patients in our locality, which resulted in a higher incidence of primary HCC.…”

“…Inevitably, it was associated with longer operating time but with similar or lowered blood loss when compared with the laparoscopic group or open group. A comparative study by Ji et al showed that the mean operating times for robotic, laparoscopic and open resections were 338, 130 and 205 min, while mean blood loss was 280, 350 and 470 mL, respectively [17]. Berber et al [18] compared robotic groups' mean operating time with laparoscopic groups: 259 vs. 234 min with similar estimated blood loss.…”

Robotik Gastrointestinal Cerrahide Güncel Uygulama

“…complications, bile leakage being the most commonly seen (17). Ji et al reported lower complication rates in RAL hepatic surgery compared to laparoscopic and open surgery (7.8% vs. 10% and 12.5% respectively) (22). Yu et al from Korea compared the surgical outcomes of 206 patients who underwent left hemihepatectomy or left lateral sectionectomy via robotic and laparoscopic liver surgery.…”