ArticleAnnals of surgical oncology2026
Robotic Anatomic Segmentectomy 8 of the Liver Using a Hepatic Vein-Guided Approach and Indocyanine Green Fluorescence Imaging (With Video).
Article in Annals of surgical oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundAnatomic segmentectomy 8 of the liver is among the most technically demanding procedures, primarily because of the deep intraparenchymal location and marked anatomic variability of the segment 8 Glissonean pedicle (G8) and the inherently curved configuration of the intersegmental planes. The cranial hepatic vein-guided approach (HVGA) combined with indocyanine green (ICG) fluorescence imaging offers a rational and reproducible strategy for achieving accurate anatomic resection.
methodsThe authors performed robotic anatomic segmentectomy 8 using a stepwise strategy integrating three complementary elements: (1) cranial root-side exposure of the middle hepatic vein (MHV) to establish a stable anatomic axis, (2) intersegmental vein (ISV)-guided localization of G8 exploiting the consistent anatomic relationship between the ISV between segments 5 and 8 and the G8 root, and (3) ICG-negative staining for real-time delineation of the segment 8 portal territory.
resultsThe operative time was 180 min, with an estimated blood loss of 10 mL. No intraoperative transfusion was required. The Pringle maneuver was applied intermittently for a cumulative duration of 45 min. A 30-mm hepatocellular carcinoma was resected with a clear surgical margin of 11 mm. The postoperative course was uneventful, and the patient was discharged on postoperative day 7.
conclusionsRobotic anatomic segmentectomy 8 using a cranial HVGA integrated with ICG fluorescence imaging enables precise identification of G8 and accurate navigation along the curved intersegmental planes of S8. This three-element integrated strategy provides an anatomically grounded, reproducible framework for safe and complex robotic anatomic segmentectomy.
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