ArticleSurgical endoscopy2022
Improving safety of robotic major hepatectomy with extrahepatic inflow control and laparoscopic CUSA parenchymal transection: technical description and initial experience.
Article in Surgical endoscopy, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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16 citing papers in PubMed, 35 citations in OpenAlex.
- Surgeon-controlled robotic CUSA technique for liver parenchymal transection.Surgical endoscopy · 2026Article
- Robotic Hepatectomy for Primary Liver Cancer.Annals of surgical oncology · 2026Review
- Advancing the standard in donor hepatectomy: reflections on pure laparoscopic donor right hepatectomy and the evolving role of minimally invasive approaches.Hepatobiliary surgery and nutrition · 2026Article
- Association of operative approach with adverse events following hepatic resections.Surgery open science · 2025Article
- Surgical protocol of robotic liver resection using a two-surgeon technique (TAKUMI-3): a technical note and initial outcomes.World journal of surgical oncology · 2025Article
- One hundred and fifty-two robotic hepatectomies at a North American hepatobiliary program: Evolution of practice, learning curve, appraisal of outcomes, and cost analysis.Surgical endoscopy · 2025Article
- Robotic Hepatic Parenchymal Transection Techniques: A Choice Between Imperfect Tools.Annals of surgical oncology · 2025Article
- Ultrasonic surgical aspiration (CUSA®) for laparoscopic excision of endometriosis: a prospective case series demonstrating safety and precision in fertility-preserving surgery.Frontiers in surgery · 2025Article
- Article
- Efficacy and safety of robotic versus laparoscopic liver resection for hepatocellular carcinoma: a propensity score-matched retrospective cohort study.Hepatology international · 2024Article
- Is it now possible to transition from laparoscopic liver resection to robotic liver resection?Hepatobiliary surgery and nutrition · 2024Article
- Microfracture-coagulation for the real robotic liver parenchymal transection.Journal of robotic surgery · 2024Article
- A systematic review and meta-analysis of blood transfusion rates during liver resection by country.Annals of surgical treatment and research · 2023Article
- Robotic Left Anatomical Hepatectomy For Intrahepatic Cholangiocarcinoma. Technique of Hepatic Vein Dissection Without CUSA.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2023Article
- Robotic Versus Laparoscopic Hepatectomy: A Single Surgeon Experience of 629 Consecutive Minimally Invasive Liver Resections.World journal of surgery · 2023Article
- What Is the Current Role and What Are the Prospects of the Robotic Approach in Liver Surgery?Cancers · 2022Review
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Authors and funding
10 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundBlood loss is a major determinant of outcomes following hepatectomy. Robotic technology enables hepatobiliary surgeons to mimic open techniques for inflow control and parenchymal transection during major hepatectomy, increasing the ability to minimize blood loss and perform safe liver resections.
methodsInitial experience of 20 consecutive major robotic hepatectomies from November 2018 to July 2020 at two co-located institutions was reviewed. All cases were performed with extrahepatic inflow control and parenchymal transection with the laparoscopic cavitron ultrasonic surgical aspirator (CUSA), and a technical description is illustrated. Clinical characteristics, operative data, and surgical outcomes were retrospectively analyzed.
resultsThe median (range) patient age was 58 years (20-76) and the majority of 14 (70%) patients were ASA III-IV. There were 12 (60%) resections for malignancy and the median tumor size was 6.2 cm (1.2-14.6). Right or extended right hepatectomy was the most common procedure (12 or 60% of cases). There were 7 (35%) left or extended left hepatectomies and 1 (5%) central hepatectomy. The median operative time was 420 (177-622) minutes. Median estimated blood loss was 300 mL (25-800 mL). One (5%) case was converted to open. Two (10%) patients required blood transfusion. The median length of stay was 3 (1-6) days. Major complications included 1 (5%) Clavien-Dindo IIIa bile leak requiring percutaneous drainage placement. There was no 90-day mortality.
conclusionAdvanced techniques to reduce blood loss in robotic hepatectomy may optimize safety and minimize morbidity in these complex minimally invasive procedures.
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