Robot assisted Left Hepatectomy for HCC

This video was entered by Dr. Srinivasan Ramachandran in the 2022 KS International Robotic Surgery Innovation Awards, sponsored by the Vattikuti Foundation. It was featured in the Vattikuti Symposium ‘Humans at the Cutting Edge of Robotic Surgery,’ held in Miami, Florida November 19, 2022.

Here is the Abstract:

Robot assisted Left Hepatectomy for HCC

This video shows a robot assisted minimally invasive liver resection.

The patient was a 63 year old male with a 8*6cm HCC in left lobe of liver.

The DaVinci robot Si platform was used for the inflow vascular control and liver mobilisation. Stryker#1688 laparoscopic system was during liver parenchymal transection . Indocyanin green dye was used for liver demarcation. The Firefly of the DaVinci robot only shows either the ICG or white light image at a time. One has to switch between the two repeatedly during the surgery, in order to maintain the correct liver transection plane. The Stryker#1688 has an overlay mode which shows both ICG and white light image together which makes it easier during liver transection. The energy device used for transection was the Olympus Thunderbeat. This has both harmonic and bipolar functions, which can seal small vessels thereby avoiding multiple instrument exchanges.

The specimen was removed using a Pfannensteil incision, which lead to a quick recovery enabling the patient to be discharged in 4 days.
Minimally invasive liver resection was possible only due to the dexterity of the robot, which helped in vascular dissection and control. Otherwise, the patient would have had an open resection through a large Makuchi incision.

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