Robotic hepatobiliary and pancreatic surgery: a cohort study

Chan, Oliver; Tang, Chung; Lai, Eric; Yang, George; Li, Michael
July 2011
Journal of Hepato -- Biliary -- Pancreatic Sciences;Jul2011, Vol. 18 Issue 4, p471
Academic Journal
Background: Robotic surgery has emerged as one of the most promising surgical advances since its launch at the turn of the millennium. Despite its worldwide acceptance in many different surgical specialties, the use of robotic assistance in the field of hepatobiliary and pancreatic (HBP) surgery remains relatively unexplored. This article aims to evaluate the efficacy and outcomes of robotic HBP surgery in a single surgical center. Methods: Between May 2009 and December 2010, all patients admitted to our unit for robotic HBP surgery were evaluated. A retrospective analysis of a prospectively maintained database on clinical outcomes was performed. Results: There were 55 robotic HBP operations performed during the study period. There were 27 robotic liver resections (left lateral sectionectomies n = 17, left hepatectomy n = 1, other segmentectomies n = 2 and wedge resections n = 7), 12 robotic pancreatic procedures (Whipple's operations n = 8, spleen-preserving distal pancreatectomies n = 2, double bypass n = 1 and cystojejunostomy n = 1) and 16 biliary procedures (biliary enteric bypass n = 9, bile duct exploration and related procedures n = 7). The median postoperative hospital stays for robotic liver resections, biliary procedures and pancreatic operations were 5.5 days (range 3-11 days), 6 days (range 4-11 days) and 12 days (range 6-21 days), respectively. Morbidities for liver resection, biliary procedures and pancreatic operations were 7.4, 18 and 33%, respectively. There was no mortality in our series. Conclusions: Robotic surgery is feasible and can be safely performed in patients with complicated HBP pathologies. Further evaluation with clinical trials is required to validate its real benefits.


Related Articles

  • The challenges of resident training in complex hepatic, pancreatic, and biliary procedures. Helling, Thomas S.; Khandelwal, Anjay // Journal of Gastrointestinal Surgery;Jan2008, Vol. 12 Issue 1, p153 

    Operations on the liver and pancreas have fallen within the domain of the general surgeon and have been part of general surgery training. The more complex procedures involving these organs are limited in number in most general surgery residencies and do not afford an opportunity for vast...

  • Laparoscopic hepatectomy for hepatolithiasis: a feasibility and safety study in 29 patients. Xiujun Cai; Yifan Wang; Hong Yu; Xiao Liang; Shuyou Peng // Surgical Endoscopy;Jul2007, Vol. 21 Issue 7, p1074 

    Hepatolithiasis is a prevalent disease in Southeast Asia. Heaptectomy was considered the best treatment for majority of cases. Laparoscopic hepatectomy is a new procedure for liver lesions that uses a minimal invasive approach. The aim of this study was to evaluate the feasibility and safety of...

  • Impact of Blood Transfusions and Transfusion Practices on Long-Term Outcome Following Hepatopancreaticobiliary Surgery. Ejaz, Aslam; Spolverato, Gaya; Kim, Yuhree; Margonis, Georgios; Gupta, Rohan; Amini, Neda; Frank, Steven; Pawlik, Timothy // Journal of Gastrointestinal Surgery;May2015, Vol. 19 Issue 5, p887 

    Background: The long-term impact of transfusions with packed red blood cells (PRBC) among patients undergoing hepatopancreaticobiliary (HPB) surgery remains ill-defined. We sought to determine the impact of overall blood utilization, as well as a restrictive transfusion strategy, on long-term...

  • Technical refinements of bile duct division in living donor liver surgery. Takatsuki, Mitsuhisa; Eguchi, Susumu; Yamanouchi, Kosho; Hidaka, Masaaki; Soyama, Akihiko; Kanematsu, Takashi // Journal of Hepato -- Biliary -- Pancreatic Sciences;Mar2011, Vol. 18 Issue 2, p170 

    Background/purpose: In spite of the great risk involved, the donor bile duct division procedure has not been thoroughly addressed in the literature. The purpose of this study is to show the appropriate approach to bile duct division in living donor hepatectomy. Methods: Of 87 living donor liver...

  • Management of Bile Duct Stones in 1572 Patients Undergoing Laparoscopic Cholecystectomy. Snow, L. Lamar; Weinstein, L. Steve; Hannon, Jeffrey K.; Lane, Daniel R. // American Surgeon;Jun1999, Vol. 65 Issue 6, p530 

    Presents information on the results of a study in Alabama on bile duct stone management in patients undergoing laparoscopic cholecystectomy from March 1989 to March 1997. Materials and methods; Results; Discussion.

  • Definitive Decompression of the Biliary Tree -- Preferred Approach to Management of Choledocholithiasis and/or Associated Pathology. de Almeida, Antonia Mendes; Omar, Mussa; Gracias, Caetano Winston; dos Santos, Noel Medina // American Journal of Gastroenterology;Dec1982, Vol. 77 Issue 12, p941 

    The experience of the senior author in the management of biliary tract lithiasis and/or associated pathology is analyzed, retrospectively until 1976 and prospectively from then on, in an attempt to ascertain the most efficient manner of handling a duct requiring surgical exploration. Primary...

  • Laparoscopic management of common bile duct stones. Ebner, S.; Rechner, J.; Beller, S.; Erhart, K.; Riegler, F.M.; Szinicz, G. // Surgical Endoscopy;May2004, Vol. 18 Issue 5, p762 

    Background: While laparoscopic cholecystectomy is widely accepted for therapy of cholecystolithiasis, controversy still exists concerning the management of common bile duct stones. Besides preoperative endoscopic papillotomy followed by laparoscopic cholecystectomy and open common...

  • Cholecystectomy After Endoscopic Sphincterotomy for Common Bile Duct Stones: Is Surgery Necessary? Harris, Hobart W.; Davis, Brian R.; Vitale, Gary C. // Surgical Innovation;Sep2005, Vol. 12 Issue 3, p187 

    It has been more than 30 years since the introduction of endoscopic sphincterotomy for the management of choledocholithiasis. Once introduced, this endoscopic intervention subsequently enabled clinicians to witness the natural history of leaving the gallbladder in situ once the common duct...

  • Short rigid scope and stereo-scope designed specifically for open abdominal navigation surgery: clinical application for hepatobiliary and pancreatic surgery. Onda, Shinji; Okamoto, Tomoyoshi; Kanehira, Masaru; Fujioka, Shuichi; Suzuki, Naoki; Hattori, Asaki; Yanaga, Katsuhiko // Journal of Hepato -- Biliary -- Pancreatic Sciences;Apr2013, Vol. 20 Issue 4, p448 

    Background: We have reported the utility of an image display system using augmented reality (AR) technology in hepatobiliary surgery under laparotomy. Among several procedures, we herein report a system using a novel short rigid scope and stereo-scope, both designed specifically for open...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics