Robotic Liver Resection for Metastatic Adenocarcinoma of the Liver

Orhan Agcaoglu, MD, Dursun A Sahin, MD, Volkan Genc, MD, Jesse Gutnick, MD, Federico Aucejo, MD, Eren Berber, MD. Cleveland Clinic


Multiple studies have demonstrated the advantage of laparoscopic over open liver resection in selected patients. Recently, robotic techniques have been described for minimally invasive liver tumor resection. The aim of this video is to show our technique for partial robotic hepatectomy.

The patient is an 86 year-old man with a history of rectal cancer, status post resection of primary 8 years ago. His pathology was a stage 3 adenocarcinoma at that time. He received adjuvant chemo-radiation. In his follow up he was found to have increasing CEA levels. A PET scan showed a solitary lesion in segment V of the liver. The patient had no extrahepatic disease and comorbidities. The procedure was performed under general anesthesia through 5 trocars, including 3 ports for the robot and 2 ports for the first assistant. The liver segment V tumor was resected to clear margins robotically. The patient was discharged uneventfully on postoperative day 1. The patient is alive at 6th month follow up with no evidence of recurrence on imaging studies. This video shows the technical details of the procedure.

This case report illustrates the key steps of robotic liver surgery. Due to its resemblance to the open resection technique, we believe that the robotic technology will help advance minimally invasive liver surgery.

Session Number: VidTV3 – Video Channel Rotation Day 3
Program Number: V143

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