Totally Robotic Right Hepatectomy

Giulianotti, Pier Cristoforo

doi:10.1001/archsurg.2011.145

Cited by 110 publications

(25 citation statements)

References 28 publications

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“…The technical details of the robotic hepatectomy have been previously described. 4,19 The open cases were performed by five experienced hepatobiliary/transplant surgeons. All consecutive patients seen by the robotic, HPB surgeon were done robotically, and all patients seen by the transplant division were done open.…”

Section: Methodsmentioning

confidence: 99%

Financial Impact of the Robotic Approach in Liver Surgery: A Comparative Study of Clinical Outcomes and Costs Between the Robotic and Open Technique in a Single Institution

Daskalaki

Gonzalez-Heredia

Brown

et al. 2017

Journal of Laparoendoscopic & Advanced Surgical Techniques

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Background: One of the perceived major drawbacks of minimally invasive techniques has always been its cost. This is especially true for the robotic approach and is one of the main reasons that has prevented its wider acceptance among hospitals and surgeons. The aim of our study was to evaluate the clinical outcomes and economic impact of robotic and open liver surgery in a single institution.Methods: Sixty-eight robotic and 55 open hepatectomies were performed at our institution between January 1, 2009 and December 31, 2013. Demographics, perioperative data, and postoperative outcomes were collected and compared between the two groups. An independent company performed the financial analysis. The economic parameters comprised direct variable costs, direct fixed costs, and indirect costs.Results: Mean estimated blood loss was significantly less in the robotic group (438 versus 727.8 mL; P = .038). Overall morbidity was significantly lower in the robotic group (22% versus 40%; P = .047). Clavien III/IV complications were also lower, with 4.4% in the robotic versus 16.3% in the open group (P = .043). The length of stay in the intensive care unit (ICU) was shorter for patients who underwent a robotic procedure (2.1 versus 3.3 days; P = .004). The average total cost, including readmissions, was $37,518 for robotic surgery and $41,948 for open technique.Conclusions: Robotic liver resections had less overall morbidity, ICU, and hospital stay. This translates into decreased average costs for robotic surgery. These procedures are financially comparable to open resections and do not represent a financial burden to the hospital.

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Section: Methodsmentioning

confidence: 99%

Financial Impact of the Robotic Approach in Liver Surgery: A Comparative Study of Clinical Outcomes and Costs Between the Robotic and Open Technique in a Single Institution

Daskalaki

Gonzalez-Heredia

Brown

et al. 2017

Journal of Laparoendoscopic & Advanced Surgical Techniques

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“…There are few reported cases on the use of robotic surgery for large, right lobe, liver tumors 123. This is a case of large ICC, resected with anterior approach right hepatectomy, using the robotic platform, after a post portal vein embolization for future liver remnant volume enhancement.…”

Section: Discussionmentioning

confidence: 99%

Robotic-assisted right hepatectomy via anterior approach for intrahepatic cholangiocarcinoma

Goja

Singh

Chaudhary

et al. 2017

Ann Hepatobiliary Pancreat Surg

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Major hepatic resection, especially right hepatectomy, has been successfully performed by specialized hepatobiliary centers using the robotic platform with low morbidity, conversion rates and outcomes comparable to laparoscopic and open surgery. The authors report a case of robotic-assisted right hepatectomy done for intrahepatic cholangiocarcinoma using anterior approach, after right portal vein embolisation for future liver remnant volume enhancement.

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“…[12345] Robot-assisted gastrectomy (RAG) using the DVSS was first reported by Hashizume and Sugimachi in 2003. [6] Since then, several advancements and modifications to RAG to allow performing gastrectomy with systematic lymphadenectomy and total gastrectomy have been reported.…”

Section: Introductionmentioning

confidence: 99%

Technique of totally robotic delta-shaped anastomosis in distal gastrectomy

et al. 2017

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BACKGROUND:We aimed to clarify the utility of delta-shaped anastomosis (Delta), an intracorporeal Billroth-I anastomosis-based reconstruction technique used after laparoscopy-assisted distal gastrectomy (LADG), in robot-assisted distal gastrectomy (RADG).METHODS:RADG was performed in patients with clinical Stage I gastric cancer, and reconstruction was performed using Delta. The Delta procedure was the same as that performed after LADG, and the operator practiced the procedure in simulated settings with surgical assistants before the operation. After gastrectomy, the scope and robotic first arm were reinserted from separate ports on the right side of the patient. Then, a port on the left side of the abdomen was used as the assistant port from which a stapler was inserted, with the robotic arm in a coaxial mode. The surgical assistant performed functional end-to-end anastomosis of the remnant stomach and duodenal stump using a powered stapler.RESULTS:The mean anastomotic time in four patients who underwent Delta after RADG was 16.5 min. All patients were discharged on the post-operative day 7 without any post-operative complications or need for readmission.CONCLUSIONS:Pre-operative simulation, changes in ports for insertion of the scope and robotic first arm, continuation of the coaxial operation, and use of a powered stapler made Delta applicable for RADG. Delta can be considered as a useful reconstruction method.

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Totally Robotic Right Hepatectomy

Cited by 110 publications

References 28 publications

Financial Impact of the Robotic Approach in Liver Surgery: A Comparative Study of Clinical Outcomes and Costs Between the Robotic and Open Technique in a Single Institution

Financial Impact of the Robotic Approach in Liver Surgery: A Comparative Study of Clinical Outcomes and Costs Between the Robotic and Open Technique in a Single Institution

Robotic-assisted right hepatectomy via anterior approach for intrahepatic cholangiocarcinoma

Technique of totally robotic delta-shaped anastomosis in distal gastrectomy

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