574 Robotic Hepatic Artery Infusion (HAI) Port Placement for Liver-Directed Intra-Arterial Chemotherapy

Dr. Kushal Agrawal

Colorectal liver metastases (CRLM) and intrahepatic cholangiocarcinoma (iCCA) are often unresectable due to extensive hepatic involvement, making regional therapies essential. Hepatic artery infusion (HAI) therapy allows high local drug delivery by exploiting the hepatic artery’s predominant tumor blood supply. Traditionally performed via open surgery, port placement has evolved with robotic techniques, offering superior precision and reduced morbidity. In this first Indian experience, 17 patients with CRLM underwent robotic HAI port placement using the DaVinci X system, with preoperative CT angiography guiding vascular anatomy. The gastroduodenal artery was consistently used, and routine cholecystectomy was performed. Results demonstrated a 100% technical success rate, no conversions, minimal blood loss, and a short hospital stay, with only one minor complication. These findings confirm that robotic HAI port placement is safe, feasible, and effective, even in patients with variant anatomy. Wider adoption may enhance outcomes in advanced CRLM, supporting future larger prospective trials.

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