Technical Feasibility of Single-Port Robotic Left Lateral Sectionectomy Using the da Vinci SP

Abstract

The recent introduction of robot surgery system is bringing new innovation to the field of minimal invasive surgery. It was developed to overcome the disadvantages of conventional laparoscopic surgery. Well-known advantages of the robotic surgery such as improved vision of surgical field via three-dimentional vision, visual magnification , tremor suppression , and the flexibility and dexterity of the instruments have allowed precise and meticulous operation techniques. The da Vinci system has recently released a true single-port platform, the da Vinci SP system with 3 instrument which has the multi-joint (elbow and wrist) and flexible camera entering into one single port. We now present the first case of robotic liver resection using the da Vinci SP system, showing surgical technical feasibility. A 63-years old female presented with elevated liver function test(LFT) and abdominal pain. CT scan and MRCP shows that multiple intrahepatic duct stone at left lateral section and distal CBD stone near ampullar of vater. Thus, we removed distal CBD stone via ERCP. After performing ERCP, there were no biliary obstructive symptoms, so we doing operation after that. Docking time took 8 minites. The patient underwent successful da Vinci SP with a total operation time of 135 minutes. There was no significant intraoperative event. The patient was discharged post-operative 5 days after checking the CT scan without any surgical complication. We report a technique of left lateral sectionectomy without additional port. For active application of da Vinci SP in hepatobiliary surgery, more device development and further research are needed.