Introduction and Implementation of Robotic Liver Resection in a High Volume HPB Center

Abstract

Background: Robotic surgery is the new field of implementation of minimally invasive surgery and it could potentially offer some advantages in case of difficult liver resections (postero-superior segments). The aim of this study is to analyse our initial series of robotic hepatectomy. Materials and Methods: Clinico-patological data as well intra-operative and post-operative outcomes of all patients submitted to robotic hepatectomy between January 2017 and June 2021 were prospectively recorded in a dedicated database and analysed. Results: A total of 111 consecutive patients underwent robotic hepatectomy during the study period. 48 of patients were women (mean age 67 yo), mean BMI was 26,05 (range 19-40) and ASA class of 3. Mean size of resected lesion was 29,387 mm (range 9-72). Indications for resection were metastatic tumours (56,76 %), HCC (22,5%), cholangiocarcinoma (5,4%), gallbladder cancer (9,9%) and 6 cases of symptomatic benign lesions.30,6% of lesions (34 patients) were located in postero-superior segments. Robotic bisegmentectomy was performed in 14 patients. Robotic segmentectomy was performed in 12 patients, while in the other patients single or multiple parenchimal sparing atypical resections were performed. Mean operative time was 187,612 min. (range 60-390), and mean estimated blood loss was 130, 135 ml (range 10-1100). Mean length of hospital stay was 6 days (range 3-21). There were no postoperative deaths. Conclusions: Our initial experience with robotic liver resection demonstrated that with a good selection of patients robotic hepatectomy can be introduced safely especially in high specialized centres with excellents results also for lesions located in postero-superior segments.