Iswanto Sucandy, MD, Sharona B Ross, MD, FACS, Michael V Musumeci, BS, Alexander S Rosemurgy, MD, FACS. Florida Hospital Tampa
This video demonstrates a robotic partial right hepatectomy utilizing ipsilateral inflow vascular control in the treatment of a giant cavernous hemangioma. A 47 year old woman presented with significant right upper quadrant and flank pain. A subsequent CT scan showcased an enlarging segment 7/8 cavernous hemangioma (7.7 cm to 10cm within 1.5 years). The operation was undertaken utilizing 6 ports, one of which was occupied by an airflow/insufflation device while another was both an assistant and extraction port. To begin, the liver was mobilized. The cystic duct and cystic artery were divided in order to utilize the gallbladder for retraction and exposure as the operation proceed. Bulldog clamps were placed upon the right branch of the portal vein and the right hepatic artery. Intraoperative ultrasound was then used to localize the edges of the giant cavernous hemangioma and the appropriate line of transection was established using a hook cautery across the liver. A suture was placed in a figure of eight fashion on the liver to act as a handle and facilitate exposure. Utilizing a vessel sealer, stapling device, hook cautery, and eventually the Aquamantys, the dissection was completed without notable blood loss. The liver specimen was placed in an EndoCatch bag as it was removed out through the applied port site. Finally, the gallbladder was removed and the cut edge of the liver was inspected again to ensure no bleeding. At its conclusion, the operation entailed a near total right hepatectomy as segments 5, 6, 7, and part of 8 were removed. The patient tolerated the operation well and was discharged postop day 2.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 87823
Program Number: V068
Presentation Session: Robotics 1 Session
Presentation Type: Video
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