Robotic anatomical resection of liver segment 4 with glissonian approach and selective hepatic artery clamping

Abstract

Minimally invasive surgery has increased in the last decade, including liver procedures. The laparoscopic technique is considered safe and effective. However, this technique is still used in selected patients and in specialized centers with greater surgical volume Conventional laparoscopy has some limitations, including twodimensional view, unstable camera platform, and the use of rigid instruments with a limited degree of motion, which makes complex liver resection more difficult. Robotic system provides a good opportunity to perform even difficult procedures in the minimally invasive context but still restricted to few trained surgeons. The usefulness of the robotic platform in liver resection is still debated. However, patients who need complex liver procedures are good candidates for robotic approach. Procedures that require excellent accuracy and dexterity are the best candidates for robotic surgery This video shows a robotic resection of liver segment 4 using the glissonian approach and selected hepatic artery clamping in a patient with a single breast liver metastasis (FIGURES 1-2). We present the case