Abstract
Purpose: We present the case of a 78 years-old patient affected by HCV cirrhosis with a diagnosis of a single resectable 2cm HCC of the upper and lateral border of the segment II. Methods: Pre-operative work-up included liver MRI, thoracic CT-scan and blood exams. Child-Pugh score A5, MELD score 8, Platelet count normal, AFP within normal values. Gastroscopy was zithin limits. After multidisciplinary discussion a liver resection was indicated using a robotic minimally invasive approach. Results: Intraoperative ultrasound was performed to exlude other missed lesions. Parenchymal transection is then realized by the kelly clamp crushing technique under intermittent vascular clamping (extracorporeal control). There were no intraoperative complications, the post-operative course was uneventful with patient discharged at POD 1. Pathological findings: pT1 moderately differentiated hepatocellular carcinoma (Edmonson-Steiner grade 2 to 3), R0 (complete resection). Conclusion: robotic liver resection can be performed safely, with a magnified vision and optimal control of the surgical field.
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