TY - JOUR
T1 - Robotic liver resection of segment 7
T2 - A step-by-step description of the technique
AU - Nota, Carolijn L
AU - Molenaar, Iq Quintus
AU - Borel Rinkes, Inne Hm
AU - Hagendoorn, Jeroen
N1 - Funding Information:
The authors like to thank prof. dr. Yuman Fong (City of Hope Comprehensive Cancer Center, Los Angeles, USA) for his extensive help during the set-up of the robotic liver surgery program at UMC Utrecht.
Publisher Copyright:
© 2020 Elsevier Ltd
Copyright:
Copyright 2020 Elsevier B.V., All rights reserved.
PY - 2020/9
Y1 - 2020/9
N2 - BACKGROUND: Robotic surgery is increasingly employed in complex procedures such as liver resection. Minor resections of the posterosuperior segments might benefit in particular from a robotic approach, since the size of the incision dominates the postoperative recovery rather than the extent of the resection [1]. We aimed to provide a standardized, step-wise guide to robotic liver resection of segment 7.METHODS: This video illustrates, step-by-step, robotic segment 7 resection. Patients are placed in left lateral position, slight anti-Trendelenburg. Three robotic ports are used and one conventional laparoscopic port is placed for bedside assistance. Next, segment 7 is mobilized. Intraoperative ultrasound is used to delineate the tumor and ensure a safe oncologic margin. The EndoWrist ® One™ Vessel Sealer (Extend) (Intuitive Surgical Inc., Sunnyvale, CA, USA) is used for transection of the hepatic parenchyma, combined with a bipolar Maryland Forceps (Intuitive Surgical, Sunnyvale, California, USA). Hem-o-lok clips (Teleflex Inc., Morrisville, NC, USA) or laparoscopic staplers (Medtronic, Minneapolis, MN, USA) are used to control the hepatic pedicle. A pringle manoeuvre is applied when deemed appropriate. To ensure hemostasis and biliostasis, TachoSil (Takeda Nederland b.v. Takeda, Zurich, Switzerland) is applied to the resection surface. The specimen is extracted through an enlarged trocar incision.RESULTS: This video illustrates robotic liver resection of segment 7 in a 72-year-old male with a past medical history of colorectal cancer. New, resectable liver metastases were detected during follow-up. The procedure was completed fully robotically. No postoperative complications occurred and the patient was discharged on postoperative day one.CONCLUSION: This video provides a step-by-step guide to robotic liver resection of segment 7.
AB - BACKGROUND: Robotic surgery is increasingly employed in complex procedures such as liver resection. Minor resections of the posterosuperior segments might benefit in particular from a robotic approach, since the size of the incision dominates the postoperative recovery rather than the extent of the resection [1]. We aimed to provide a standardized, step-wise guide to robotic liver resection of segment 7.METHODS: This video illustrates, step-by-step, robotic segment 7 resection. Patients are placed in left lateral position, slight anti-Trendelenburg. Three robotic ports are used and one conventional laparoscopic port is placed for bedside assistance. Next, segment 7 is mobilized. Intraoperative ultrasound is used to delineate the tumor and ensure a safe oncologic margin. The EndoWrist ® One™ Vessel Sealer (Extend) (Intuitive Surgical Inc., Sunnyvale, CA, USA) is used for transection of the hepatic parenchyma, combined with a bipolar Maryland Forceps (Intuitive Surgical, Sunnyvale, California, USA). Hem-o-lok clips (Teleflex Inc., Morrisville, NC, USA) or laparoscopic staplers (Medtronic, Minneapolis, MN, USA) are used to control the hepatic pedicle. A pringle manoeuvre is applied when deemed appropriate. To ensure hemostasis and biliostasis, TachoSil (Takeda Nederland b.v. Takeda, Zurich, Switzerland) is applied to the resection surface. The specimen is extracted through an enlarged trocar incision.RESULTS: This video illustrates robotic liver resection of segment 7 in a 72-year-old male with a past medical history of colorectal cancer. New, resectable liver metastases were detected during follow-up. The procedure was completed fully robotically. No postoperative complications occurred and the patient was discharged on postoperative day one.CONCLUSION: This video provides a step-by-step guide to robotic liver resection of segment 7.
KW - Robotic hepatectomy
KW - Minimally invasive surgery
KW - Liver resection
UR - http://www.scopus.com/inward/record.url?scp=85084385415&partnerID=8YFLogxK
U2 - 10.1016/j.suronc.2020.04.028
DO - 10.1016/j.suronc.2020.04.028
M3 - Article
C2 - 32891331
SN - 0960-7404
VL - 34
SP - 206
EP - 207
JO - Surgical Oncology
JF - Surgical Oncology
ER -