Robotic liver resection from exploration to maturity—single center experience

Abstract

By 2022, more than 2000 cases of robotic liver surgeries have been completed in our medical center. Based on the large number of robotic operation experience, recommendations on how to perform robotic liver resection were summarized in this paper. Robotic hepatectomy is a safe and feasible technique. Firstly, a patterned trocar placement scheme and individualized adjustment method are established. Secondly, an improved intracorporeal Pringle maneuver is founded. Thirdly, with reasonable combined use of three-dimensional reconstruction, indocyanine green (ICG) fluorescent staining, intraoperative ultra-sound image and intrahepatic/extrahepatic landmarks, an ideal hepatectomy plane would be more likely obtained. In this paper, robotic liver surgeries are divided into three types according to the difficulty of learning and a safe and feasible advanced learning process is proposed. Experiences in this paper may provide some help to those centers planning to carry out robotic liver surgery.