Robotic Left Hepatectomy Using the Glissonean Approach and Saline-Linked Bipolar Clamp-Crush Technique

IF 2.3 3区医学 Q2 SURGERY

International Journal of Medical Robotics and Computer Assisted Surgery Pub Date : 2024-09-24 DOI:10.1002/rcs.2674

Masatoshi Kajiwara, Shigetoshi Naito, Takahide Sasaki, Ryo Nakashima, Suguru Hasegawa

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引用次数: 0

Abstract

Background

We have previously reported a saline-linked bipolar clamp-crush technique as a novel robotic liver resection method. Herein, we present the surgical techniques and outcomes of robotic left hepatectomy using the Glissonean approach and our liver transection technique.

Methods

The key procedures included the following: (1) encircling the left Glissonean pedicle using the Tip-Up fenestrated grasper, (2) dissecting the liver parenchyma using the saline-linked bipolar clamp-crush technique, (3) moving the endoscope one trocar to the right to facilitate visualisation of the liver transection plane, and (4) stapling the left pedicle and left hepatic vein. Seven robotic left hepatectomies were performed.

Results

The median operative time and estimated blood loss were 395 min and 50 mL, respectively. The median length of postoperative hospital stay was 9 days. Pneumothorax was the only severe postoperative complication.

Conclusions

Robotics left hepatectomy using the Glissonean approach and the saline-linked bipolar clamp-crush technique appears safe and feasible.

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使用格利索内入路和生理盐水连接双极钳-挤压技术的机器人左肝脏切除术

背景：我们曾报道过一种新型机器人肝脏切除方法--生理盐水连接双极钳夹技术。在此，我们介绍了使用 Glissonean 方法和我们的肝横断技术进行机器人左肝切除术的手术技巧和结果：方法：主要步骤包括以下几点：方法：主要步骤包括：(1)使用Tip-Up栅栏式抓取器环绕左侧Glissonean蒂；(2)使用生理盐水连接双极钳-挤压技术解剖肝实质；(3)将内窥镜向右移动一个套管以方便观察肝横断面；(4)缝合左侧蒂和左侧肝静脉。共进行了七例机器人左肝切除术：中位手术时间和估计失血量分别为395分钟和50毫升。术后住院时间中位数为 9 天。气胸是唯一严重的术后并发症：采用格利索内入路和生理盐水连接双极钳-挤压技术的机器人左肝切除术似乎安全可行。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Medical Robotics and Computer Assisted Surgery 医学-外科

CiteScore

4.50

自引率

12.00%

发文量

131

审稿时长

6-12 weeks

期刊介绍： The International Journal of Medical Robotics and Computer Assisted Surgery provides a cross-disciplinary platform for presenting the latest developments in robotics and computer assisted technologies for medical applications. The journal publishes cutting-edge papers and expert reviews, complemented by commentaries, correspondence and conference highlights that stimulate discussion and exchange of ideas. Areas of interest include robotic surgery aids and systems, operative planning tools, medical imaging and visualisation, simulation and navigation, virtual reality, intuitive command and control systems, haptics and sensor technologies. In addition to research and surgical planning studies, the journal welcomes papers detailing clinical trials and applications of computer-assisted workflows and robotic systems in neurosurgery, urology, paediatric, orthopaedic, craniofacial, cardiovascular, thoraco-abdominal, musculoskeletal and visceral surgery. Articles providing critical analysis of clinical trials, assessment of the benefits and risks of the application of these technologies, commenting on ease of use, or addressing surgical education and training issues are also encouraged. The journal aims to foster a community that encompasses medical practitioners, researchers, and engineers and computer scientists developing robotic systems and computational tools in academic and commercial environments, with the intention of promoting and developing these exciting areas of medical technology.