Publication: Short-term outcomes of robotic liver resection: An initial single-institution experience.
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Identifiers
Date
2021-12-25
Authors
Duran, Manuel
Briceño, Javier
Padial, Ana
Anelli, Ferdinando Massimiliano
Sanchez-Hidalgo, Juan Manuel
Ayllon, Maria Dolores
Calleja-Lozano, Rafael
Garcia-Gaitan, Carmen
Advisors
Journal Title
Journal ISSN
Volume Title
Publisher
Baishideng Publishing Group Co
Abstract
Liver surgery has traditionally been characterized by the complexity of its procedures and potentially high rates of morbidity and mortality in inexperienced hands. The robotic approach has gradually been introduced in liver surgery and has increased notably in recent years. However, few centers currently perform robotic liver surgery and experiences in robot-assisted surgical procedures continue to be limited compared to the laparoscopic approach. To analyze the outcomes and feasibility of an initial robotic liver program implemented in an experienced laparoscopic hepatobiliary center. A total of forty consecutive patients underwent robotic liver resection (da Vinci Xi, intuitive.com, United States) between June 2019 and January 2021. Patients were prospectively followed and retrospectively reviewed. Clinicopathological characteristics and perioperative and short-term outcomes were analyzed. Data are expressed as mean and standard deviation. The study was approved by the Institutional Review Board. The mean age of patients was 59.55 years, of which 18 (45%) were female. The mean body mass index was 29.41 kg/m². Nine patients (22.5%) were cirrhotic. Patients were divided by type of resection as follows: Ten segmentectomies, three wedge resections, ten left lateral sectionectomies, six bisegmentectomies (two V-VI bisegmentectomies and four IVb-V bisegmentectomies), two right anterior sectionectomies, five left hepatectomies and two right hepatectomies. Malignant lesions occurred in twenty-nine (72.5%) of the patients. The mean operative time was 258.11 min and two patients were transfused intraoperatively (5%). Inflow occlusion was used in thirty cases (75%) and the mean total clamping time was 32.62 min. There was a single conversion due to uncontrollable hemorrhage. Major postoperative complications (Clavien-Dindo > IIIb) occurred in three patients (7.5%) and mortality in one (2.5%). No patient required readmission to the hospital. The mean hospital stay was 5.6 d. Although robotic hepatectomy is a safe and feasible procedure with favorable short-term outcomes, it involves a demanding learning curve that requires a high level of training, skill and dexterity.
Description
MeSH Terms
Hepatectomy
Robotic surgical procedures
Body mass index
Length of stay
Retrospective studies
Operative time
Ethics committees, research
Constriction
Feasibility studies
Learning curve
Robotic surgical procedures
Body mass index
Length of stay
Retrospective studies
Operative time
Ethics committees, research
Constriction
Feasibility studies
Learning curve
DeCS Terms
Comités de ética en investigación
Índice de masa corporal
Constricción
Curva de aprendizaje
Estudios retrospectivos
Estudios de factibilidad
Hepatectomía
Procedimientos quirúrgicos robotizados
Tempo operativo
Tiempo de internación
Índice de masa corporal
Constricción
Curva de aprendizaje
Estudios retrospectivos
Estudios de factibilidad
Hepatectomía
Procedimientos quirúrgicos robotizados
Tempo operativo
Tiempo de internación
CIE Terms
Keywords
Da vinci, Hepatectomy, Liver surgery, Minimally invasive surgery, Robotics
Citation
Durán M, Briceño J, Padial A, Anelli FM, Sánchez-Hidalgo JM, Ayllón MD, et al. Short-term outcomes of robotic liver resection: An initial single-institution experience. World J Hepatol. 2022 Jan 27;14(1):224-233