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Laparoscopic robot-assisted resection of tumors located in posterosuperior liver segments

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Abstract

Laparoscopic resection of liver tumors located in the posterosuperior segments is a challenging operation that could be facilitated by robotic assistance. Laparoscopic resection of 12 tumors located in posterosuperior segments (IVa: 1; VII: 5; VIII: 6) was carried out under robotic assistance. All patients had a single tumor nodule. Data were collected prospectively and analyzed retrospectively. Surgery required a mean of 260.4 min (115–430) and was completed laparoscopically in all but one patient, who required conversion to mini-laparotomy because of intolerance of pneumoperitoneum (8.3 %). Mean estimated blood loss was 252.7 ml (50–600), making transfusion necessary in 3 patients (25.0 %). Post-operative complications occurred in 4 patients (33.3 %), being of Clavien–Dindo grade II in 3 patients (25.0 %) and Clavien–Dindo grade IV in 1 patient (8.3 %). Reoperation was required in 1 patient, who subsequently had a long hospital stay, because of decompensated cirrhosis. Median length of hospital stay was 8.5 days (7–96). No patient was readmitted. Pathology showed hepatocellular carcinoma in 7 patients (58.3 %), liver metastasis in 2 patients (16.6 %), and hepatic adenoma, focal nodular hyperplasia, and hemangioma in one patient each (8.3 %). All patients had a margin negative resection. After a mean follow-up period of 21.4 months (±24.4), no patient with malignant histology developed recurrence. Our initial experience confirms that laparoscopic robot-assisted resection of tumors located in the posterosuperior segments is feasible. Further experience is needed before final conclusions can be drawn and meaningful comparison with other surgical techniques becomes possible.

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References

  1. Gagner M, Rheault M, Dubuc J (1992) Laparoscopic partial hepatectomy for liver tumor. Surg Endosc 6:99 (abstract)

    Google Scholar 

  2. Hibi T, Cherqui D, Geller DA, Itano O, Kitagawa Y, Wakabayashi G (2014) International survey on technical aspects of laparoscopic liver resection: a web-based study on the global diffusion of laparoscopic liver surgery prior to the 2nd international consensus conference on laparoscopic liver resection in Iwate, Japan. J Hepatobiliary Pancreat Sci 21:737–744

    Article  PubMed  Google Scholar 

  3. Edwin B, Mala T, Gladhaug I, Fosse E, Mathisen Y, Bergan A, Søreide O (2001) Liver tumors and minimally invasive surgery: a feasibility study. J Laparoendosc Adv Surg Tech A 11:133–139

    Article  CAS  PubMed  Google Scholar 

  4. Koffron AJ, Auffenberg G, Kung R, Abecassis M (2007) Evaluation of 300 minimally invasive liver resections at a single institution: less is more. Ann Surg 246:385–392

    Article  PubMed Central  PubMed  Google Scholar 

  5. Nguyen KT, Gamblin TC, Geller DA (2009) World review of laparoscopic liver resection—2804 patients. Ann Surg 250:831–841

    Article  PubMed  Google Scholar 

  6. Buell JF, Cherqui D, Geller DA, O’Rourke N, Iannitti D, Dagher I, Koffron AJ, Thomas M, Gayet B, Han HS, Wakabayashi G, Belli G, Kaneko H, Ker CG, Scatton O, Laurent A, Abdalla EK, Chaudhury P, Dutson E, Gamblin C, D’Angelica M, Nagorney D, Testa G, Labow D, Manas D, Poon RT, Nelson H, Martin R, Clary B, Pinson WC, Martinie J, Vauthey JN, Goldstein R, Roayaie S, Barlet D, Espat J, Abecassis M, Rees M, Fong Y, McMasters KM, Broelsch C, Busuttil R, Belghiti J, Strasberg S, Chari RS, World Consensus Conference on Laparoscopic Surgery (2009) The international position on laparoscopic liver surgery. The Louisville statement. Ann Surg 250:825–830

    Article  PubMed  Google Scholar 

  7. Coles SR, Besselink MG, Serin KR, Alsaati H, Di Gioia P, Samim M, Pearce NW, Abu Hilal M (2015). Total laparoscopic management of lesions involving liver segment 7. Surg Endosc. doi:10.1007/S00464-014-4052-2

  8. Nomi T, Fuks D, Agrawal A, Kawaguchi Y, Ogiso S, Gayet B (2015) Totally laparoscopic right hepatectomy combined with resection of the inferior vena cava by anterior approach. Ann Surg Oncol 22:851

    Article  PubMed  Google Scholar 

  9. Casciola L, Patriti A, Ceccarelli G, Bartoli A, Ceribelli C, Spaziani A (2011) Robot-assisted parenchymal-sparing liver surgery including lesions located in the posterosuperior segments. Surg Endosc 25:3815–3824

    Article  PubMed  Google Scholar 

  10. Wakabayashi G, Cherqui D, Geller DA, Buell JF, Kaneko H, Han HS, Asbun H, O’Rourke N, Tanabe M, Koffron AJ, Tsung A, Soubrane O, Machado MA, Gayet B, Troisi RI, Pessaux P, Van Dam RM, Scatton O, Abu Hilal M, Belli G, Kwon CH, Edwin B, Choi GH, Aldrighetti LA, Cai X, Cleary S, Chen KH, Schön MR, Sugioka A, Tang CN, Herman P, Pekolj J, Chen XP, Dagher I, Jarnagin W, Yamamoto M, Strong R, Jagannath P, Lo CM, Clavien PA, Kokudo N, Barkun J, Strasberg SM (2015) Recommendations for laparoscopic liver resection. A report from the second international consensus conference held in Morioka. Ann Surg 261:619–629

    PubMed  Google Scholar 

  11. Ban D, Tanabe M, Ito H, Otsuka Y, Nitta H, Abe Y, Hasegawa Y, Katagiri T, Takagi C, Itano O, Kaneko H, Wakabayashi G (2014) A novel difficulty scoring system for laparoscopic liver resection. J Hepatobiliary Pancreat Sci 21:745–753

    Article  PubMed  Google Scholar 

  12. Boggi U, Caniglia F, Amorese G (2014) Laparoscopic robot-assisted major hepatectomy. J Hepatobiliary Pancreat Sci 21:3–10

    Article  PubMed  Google Scholar 

  13. Terminology Committee of the IHPBA (2000) Terminology of liver anatomy and re-sections. HPB 2:333–339

    Google Scholar 

  14. Dindo D, Demartines N, Clavien PA (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 240:205–213

    Article  PubMed Central  PubMed  Google Scholar 

  15. Autschbach R, Onnasch JF, Falk V, Walther T, Krüger M, Schilling LO, Mohr FW (2000) The Leipzig experience with robotic valve surgery. J Card Surg 15:82–87

    Article  CAS  PubMed  Google Scholar 

  16. Algarni KD, Suri RM, Daly RC (2014). Robotic-assisted mitral valve repair: surgical technique. Multimed Man Cardiothorac Surg. doi:10.1093/mmcts/mmu022

  17. Spampinato MG, Coratti A, Bianco L, Caniglia F, Laurenzi A, Puleo F, Ettorre GM, Boggi U (2014) Perioperative outcomes of laparoscopic and robot-assisted major hepatectomies: an Italian multi-institutional comparative study. Surg Endosc 28:2973–2979

    Article  PubMed  Google Scholar 

  18. Boggi U, Signori S, De Lio N, Perrone VG, Vistoli F, Belluomini M, Cappelli C, Amorese G, Mosca F (2013) Feasibility of robotic pancreaticoduodenectomy. Br J Surg 100:917–925

    Article  CAS  PubMed  Google Scholar 

  19. Waters JA, Canal DF, Wiebke EA, Dumas RP, Beane JD, Aguilar-Saavedra JR, Ball CG, House MG, Zyromski NJ, Nakeeb A, Pitt HA, Lillemoe KD, Schmidt CM (2010) Robotic distal pancreatectomy: cost effective? Surgery 148:814–823

    Article  PubMed  Google Scholar 

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Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Standard

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Research involving human participants or animals

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent

Patients were extensively counseled about their disease, the operation that was planned, and the use of robotic assistance. All patients signed an informed consent.

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Authors and Affiliations

  1. Division of General and Transplant Surgery, University of Pisa, Pisa, Italy

    Ugo Boggi, Fabio Caniglia, Fabio Vistoli, Francesca Costa, Erika Pieroni & Vittorio Grazio Perrone

  2. Azienda Ospedaliera Universitaria Pisana, Università di Pisa, Via Paradisa 2, 56124, Pisa, Italy

    Ugo Boggi

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  1. Ugo Boggi
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  2. Fabio Caniglia
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  3. Fabio Vistoli
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  4. Francesca Costa
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  5. Erika Pieroni
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  6. Vittorio Grazio Perrone
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Correspondence to Ugo Boggi.

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Boggi, U., Caniglia, F., Vistoli, F. et al. Laparoscopic robot-assisted resection of tumors located in posterosuperior liver segments. Updates Surg 67, 177–183 (2015). https://doi.org/10.1007/s13304-015-0304-5

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  • DOI: https://doi.org/10.1007/s13304-015-0304-5

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