ArticleJournal of gastrointestinal oncology2025
Four clamp-crush techniques in robotic hepatectomy (with video).
Article in Journal of gastrointestinal oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.
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Who cites it
4 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Updated overview of robotic hepatic parenchymal transection techniques: technical developments, international perspectives, and future directions.Journal of robotic surgery · 2026Pooled it
- Bona Fide Intersegmental Plane Hepatectomy Along the Glissonean Branches (BIPHG).Annals of gastroenterological surgery · 2026Review
- Surgeon-controlled robotic CUSA technique for liver parenchymal transection.Surgical endoscopy · 2026Article
- Bipolar coagulation techniques versus the clamp-crush technique for elective liver resection.The Cochrane database of systematic reviews · 2026Article
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Authors and funding
13 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Recently, reports of robotic hepatectomies have increased. In a laparoscopic hepatectomy, various energy devices are used for parenchymal transections, especially the clamp-crush method and the Cavitron Ultrasonic Surgical Aspirator (CUSA) system are popular; however, there is no CUSA that can be operated from the robot console. We believe that conventional clamp-crush method can be classified into four categories and have tried to verbalize them. We aim to explain the four types of clamp-crush techniques of robotic hepatectomy that we have performed and to assess their outcomes, safety, and feasibility. The data of patients who underwent robotic hepatectomy at Iwate Medical University Hospital between June 2022 and April 2024 were retrospectively reviewed. For comparison, 298 patients who underwent pure laparoscopic hepatectomy at Iwate Medical University Hospital between January 2014 and December 2020 were enrolled and analyzed. Our four clamp-crush techniques (Clamp, Peck, Open, Sweep) are demonstrated in the video clips provided with our study's electronic data. In the present study, 58 patients were included. In 27 cases (46.6%), a limited resection was performed; in 9 cases (15.5%), a subsegmentectomy; in 15 cases (25.9%), a sectionectomy; and in 7 cases (12.1%), a hemihepatectomy. The mean operative time was 205.9±90.5 min, and the mean intraoperative blood loss was 103.1±200.7 mL. There were no cases of conversion to a laparotomy. In comparison with laparoscopic hepatectomies, there were no significant differences in perioperative outcomes. The present findings indicate that robotic hepatectomies are safe and feasible in high-volume specialized centers with a team experienced in laparoscopic liver surgeries. It is possible to transition from laparoscopic hepatectomy to robotic hepatectomy without stress due to the fact that the same four clamp-crush techniques that are used in laparoscopic hepatectomy, which can be done in a robotic hepatectomy.
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