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Robotic Right Hepatectomy

Pier Cristoforo Giulianotti, MD; Fabio Sbrana, MD; Giuseppe Caravaglios, MD; Francesco Bianco, MD

Product Details
Product ID: ACS-2499
Year Produced: 2006
Length: 11 min.
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Minimally invasive approach to hepatic resections is limited by technical difficulties. Robotic-assisted-surgery seems to reduce these limits making easier a minimally invasive approach to major hepatic resections. Since March 2005 have been performed at our center 5 full robotic right hepatectomies. The case of a 69-years-old male with colorectal liver metastases of the segments VI-VII is reported. We performed a full robotic right hepatectomy. The procedure was carried out without Pringle's manouver by selective vessels ligation. Before hepatic mobilization, the anterior aspect of inferior vena cava was dissected. The accessory hepatic veins were sectioned. The parenchimal transection was performed by ultrasound dissector through an anterior approach. The main right sovraepatic vein was sectioned intraparenchimally by a vascular. Intraoperative blood losses were negligible. No major complications were observed. The patient was discharged in good general conditions. Robot-enhanced-surgery is an evolution of standard laparoscopy: 3D stable vision, accuracy of dissections and fixed operating field transform the procedure in a bench-like microsurgery. The more interesting advantages of this technique concern facilitation and improvement in dissection of the portal pedicle avoiding Pringle's manouver, accuracy in parechiymal transection, effective control of the bleeding vessels and prevention of the bile leaks.