Iswanto Sucandy, MD, Janelle D Spence, BA, Sydni Schlosser, Sharona B Ross, MD, Alexander S Rosemurgy, MD. Florida Hospital Tampa
Introduction: The nascent robotic approach for hepatic resections for benign and malignant liver tumors is gaining momentum because of perceived efficacy and utility with reduced morbidity. Herein, in considering this, we document our outcomes with robotic liver resections.
Methods: With IRB approval, all patients undergoing robotic liver resections are prospectively followed. Patient demographics, operative outcomes, such as operative duration and estimated blood loss, length of stay (LOS), complications, and 30-day readmissions were collected and analyzed. Data are presented as median (mean ± SD).
Results: 77 patients underwent robotic liver resections. Patients age was 63 (62.1 ± 13.9) years, 57% were women, BMI was 28 (29.7 ± 9.6) Kg/m2, ASA Class was 3 (2.5 ± 0.55), and MELD score was 7 (8.0 ± 2.9). 58 (75%) of the liver resections were undertaken for malignancy [hepatocellular carcinoma (36%), metastatic colorectal cancer (31%), intrahepatic cholangiocarcinoma (10%), gallbladder cancer (7%), and other metastatic tumors (16%)], 7 (9%) were undertaken for premalignant lesions, and 12 (16%) were undertaken for benign lesions. 35% of patients underwent non-anatomical partial right hepatectomy, 21% non-anatomical partial left hepatectomy, 10% formal right hepatectomy, 13% formal left hepatectomy, and 12% central hepatectomy. 9% of patients underwent extended hepatectomy. Operative duration was 228 (264.5 ± 109.6) minutes and estimated blood loss was 150 (254.9 ± 300.4) ml. Conversion to an ‘open’ approach was necessary in two patients because of difficulty in assessing tumor margins and inability to reach a tumor located in segment 8, respectively. Length of hospital stay was 3 (4.9 ± 4.6) days. While there were no intraoperative complications, nine patients experienced postoperative complications (enterocutaneous fistula, respiratory failure, bile leak (n = 2), fluid collection (n = 2), pleural effusion, wound infection, and intra-abdominal abscess). Eight patients required readmission to the hospital within 30 days of discharge due to wound infection, bile leak, fluid collection, pneumonia, jaundice, and intractable vomiting.
Conclusion: Our data support that robotic liver resection is a safe and feasible technique in liver surgery with favorable short-term outcomes. Robotic surgical system enhances application of minimally invasive surgery for complex abdominal operation such as liver resection.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 95768
Program Number: P690
Presentation Session: Poster Session (Non CME)
Presentation Type: Poster