Robotic hepatectomy: initial experience of a single institution in Singapore

Singapore Med J. 2016 Apr;57(4):209-14. doi: 10.11622/smedj.2016024. Epub 2016 Feb 4.

Abstract

Introduction: In this study, we report our initial experience with robotic hepatectomy.

Methods: Consecutive patients who underwent robotic hepatectomy at Singapore General Hospital, Singapore, from February 2013 to February 2015 were enrolled in this study. The difficulty level of operations was graded using a novel scoring system for laparoscopic hepatectomies.

Results: During the two-year period, five consecutive robotic hepatectomies were performed (one left lateral sectionectomy, one non-anatomical segment II/III resection, one anatomical segment V resection with cholecystectomy, one extended right posterior sectionectomy and one non-anatomical segment V/VI resection). Two hepatectomies were performed for suspected hepatocellular carcinoma, two for solitary liver metastases and one for a large symptomatic haemangioma. The median age of the patients was 53 (range 38-66) years and the median tumour size was 2.5 (range 2.1-7.3) cm. The median total operation time was 340 (range 155-825) minutes and the median volume of blood loss was 300 (range 50-1,200) mL. There were no open conversions and no mortalities or major morbidities (> Clavien-Dindo Grade II). The difficulty level of the operations was graded as low in one case (Score 2), intermediate in three cases (Score 5, 6 and 6) and high in one case (Score 10). There was one minor morbidity, where the patient experienced Grade A bile leakage, which resolved spontaneously. The median length of postoperative hospital stay was 5 (range 4-7) days.

Conclusion: Our initial experience confirmed the feasibility and safety of robotic hepatectomy.

Keywords: laparoscopic hepatectomy; laparoscopic liver resection; minimally invasive hepatectomy; robotic hepatectomy; robotic liver resection.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Carcinoma, Hepatocellular / surgery*
  • Female
  • Follow-Up Studies
  • Hepatectomy / methods*
  • Humans
  • Laparoscopy / methods*
  • Length of Stay
  • Liver Neoplasms / surgery*
  • Male
  • Middle Aged
  • Operative Time
  • Prospective Studies
  • Robotics*
  • Singapore