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Deprecated: Implicit conversion from float 211.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Front+Surg 2015 ; 2 (ä): ä Nephropedia Template TP
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Pioneering Robotic Liver Surgery in Germany: First Experiences with Liver Malignancies #MMPMID26052515
Croner RS; Perrakis A; Brunner M; Matzel KE; Hohenberger W
Front Surg 2015[]; 2 (ä): ä PMID26052515show ga
Background: Minimally invasive liver surgery is growing worldwide with obvious benefits for the treated patients. These procedures maybe improved by robotic techniques, which add several innovative features. In Germany, we were the first surgical department implementing robotic assisted minimally invasive liver resections. Material and methods: Between June 2013 and March 2015, we performed robotic based minimally invasive liver resections in nine patients with malignant liver disease. Five off these patients suffered from primary and four from secondary liver malignancies. We retrospectively analyzed the perioperative variables of these patients and the oncological follow up. Results: Mean age of the patients was 63?years (range 45?71). One patient suffered from intrahepatic cholangiocellular, four from hepatocellular carcinoma, and four patients from colorectal liver metastases. In six patients, left lateral liver resection, in two cases single segment resection, and in one case minimally invasive guided liver ablation were performed. Five patients underwent previous abdominal surgery. Mean operation time was 312?min (range 115?458?min). Mean weight of the liver specimens was 182?g (range 62?260?g) and mean estimated blood loss was 251?ml (range 10?650?ml). The mean tumor size was 4.4?cm (range 3.5?5.5?cm). In all cases, R0 status was confirmed with a mean margin of 0.6?cm (range 0.1?1.5?cm). One patient developed small bowel fistula on postoperative day 5, which could be treated conservatively. No patient died. Mean hospital stay of the patients was 6?days (range 3?10?days). During a mean follow up of 12?months (range 1?21?months), two patients developed tumor recurrence. Conclusion: Robotic-based liver surgery is feasible in patients with primary and secondary liver malignancies. To achieve perioperative parameters comparable to open settings, the learning curve must be passed. Minor liver resections are good candidates to start this technique. But the huge benefits of robotic-based liver resections should be expected in extended procedures beyond minor liver resections with the currently available technology.
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