Iswanto Sucandy, MD, Sharona B Ross, MD, FACS, Janelle D Spence, BA, Sydni Schlosser, Alexander S Rosemurgy. Florida Hospital Tampa
Introduction: Metastatic colorectal cancer to liver is the most common non-primary liver malignancy. Robotic liver resection has been considered as a unique opportunity to overcome the limitations of conventional laparoscopy, therefore, it can potentially extend the indications of minimally invasive liver surgery. Robotic liver resection is still considered in developmental phase within the discipline of liver surgery. Technical details of this operation have not been widely available in the literature. Herein, we report are technique of robotic formal left hepatic lobectomy.
Methods: Techniques of robotic left hepatectomy for metastatic colon cancer to liver is described. A video is attached to this report.
Results: A 49 year old man with history of sigmoid colectomy followed by adjuvant FOLFOX and Avastin presented to the office with single 4 cm PET avid segment 4 lesion. Past medical history was unremarkable. Robotic formal left hepatic lobectomy was undertaken using a surgical system. The left hepatic lobe was mobilized by taking down the left coronary and triangular ligaments. Inflow vascular structures were anatomically dissected using extrahepatic Glissonian approach. The left hepatic artery and portal vein were ligated prior to starting parenchymal transection. Left hepatic bile duct and left hepatic vein were transected intrahepatically using linear staplers. The left hepatic lobe containing tumor was removed using a laparoscopic extraction bag. Operative time was 180 min with < 75 cc blood loss. Postoperative hospital recovery was uneventful and the patient was discharged home on postop day 3.
Conclusion: Robotic formal left hepatic lobectomy is a safe and feasible minimally invasive option for metastatic colorectal cancer to the liver with excellent outcomes. This approach should be included in the armamentarium of modern liver surgeon.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 95910
Program Number: V316
Presentation Session: Video Loop Day 3
Presentation Type: VideoLoop