Robotic-assisted right posterior segmentectomies for liver lesions: single-center experience of an evolutional method in left semi-lateral position View Full Text


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Article Info

DATE

2019-04

AUTHORS

Chao-Ying Wu, Po-Da Chen, Chih-Yuan Lee, Jin-Tung Liang, Yao-Ming Wu

ABSTRACT

Despite the popularity of minimally invasive surgery (MIS) for hepatectomy, limitations in the approach of the right posterior section of the liver remain. Although skills and approach techniques have been developed for hepatectomy of lesions in the posterior segments of the liver, most are performed laparoscopically and are limited to few experienced hands using rigid laparoscopic instruments. In this study, we tried a different approach area via the aid of a flexible robotic system. Since 2012, we have successfully completed more than 200 robotic hepatectomy procedures in our institution. Two different patient settings have been applied for right posterior segment lesions, including supine position as general setting in early cases and left semi-lateral decubitus setting in our later cases. The demographic data and perioperative outcomes between the two groups were analyzed in regard to different positioning. A total of 25 patients with right posterior segment lesions underwent robotic-assisted resection, 13 were placed in supine position and 12 in left semi-lateral position. The left semi-lateral group had significantly shorter operation time (306.0 versus 416.8 min, p = 0.023), less blood loss (203.9 versus 1092.3 mL, p = 0.030), and lower transfusion rates (0 versus 46.2%, p = 0.015). We described an evolutionary technique for robotic right posterior segmentectomies with the patient placed in left semi-lateral position. This method can be applied for most patients easily and is demonstrated as a safe and feasible approach in selected patients owing to its ability to overcome the difficulty of MIS hepatectomy for right posterior lesions. More... »

PAGES

231-237

References to SciGraph publications

  • 2009-06. Perioperative analysis of laparoscopic versus open liver resection in SURGICAL ENDOSCOPY
  • 2012-08. Robotic liver resection: technique and results of 30 consecutive procedures in SURGICAL ENDOSCOPY
  • 2011-05. Video-assisted Thoracoscopic Surgery: Hepatectomy for Liver Neoplasm in WORLD JOURNAL OF SURGERY
  • 2016-03. A systematic review of robotic-assisted liver resection and meta-analysis of robotic versus laparoscopic hepatectomy for hepatic neoplasms in SURGICAL ENDOSCOPY
  • 2014-12. Robotic versus laparoscopic liver resection: a comparative study from a single center in LANGENBECK'S ARCHIVES OF SURGERY
  • 2014-11. Traditional versus Robot-Assisted Full Laparoscopic Liver Resection: A Matched-Pair Comparative Study in WORLD JOURNAL OF SURGERY
  • 2014-08. Laparoscopic liver resection in the semiprone position for tumors in the anterosuperior and posterior segments, using a novel dual-handling technique and bipolar irrigation system in SURGICAL ENDOSCOPY
  • 2013-03. Systematic review of robotic liver resection in SURGICAL ENDOSCOPY
  • 2005-10. Nomenclature of hepatic anatomy and resections: a review of the Brisbane 2000 system in JOURNAL OF HEPATO-BILIARY-PANCREATIC SCIENCES
  • 2011-12. Robot-assisted parenchymal-sparing liver surgery including lesions located in the posterosuperior segments in SURGICAL ENDOSCOPY
  • 2008-11. Experiences of laparoscopic liver resection including lesions in the posterosuperior segments of the liver in SURGICAL ENDOSCOPY
  • 2010-07. Total laparoscopic liver resection for hepatocellular carcinoma located in all segments of the liver in SURGICAL ENDOSCOPY
  • 2013-02. Pure laparoscopic hepatectomy in semiprone position for right hepatic major resection in JOURNAL OF HEPATO-BILIARY-PANCREATIC SCIENCES
  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1007/s11701-018-0842-1

    DOI

    http://dx.doi.org/10.1007/s11701-018-0842-1

    DIMENSIONS

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    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/29995223


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