Minimal Invasive Major Liver Resection: from Laparoscopic to Robotic Approach
16:05 - 16:30, Room 104 (104講堂)
Minimal invasive major liver resection: from laparoscopic to robotic approach
Surgery performed by minimal invasive approach had been shown with the benefits of shorter hospital stay, better postoperative recovery and cosmesis of wound. The percentage of major liver resection via minimal invasive approach increased in the past five years contributed by both accumulated surgical experience and availability of instruments. Robotic surgical system has the advantages of 3D surgical vision and flexibility which have the potential to overcome these existed laparoscopic limitations , especially for challenging liver resection.
We had set up the laparoscopic liver surgery program in NTUH since 2007, and performed 69 cases till the end of 2011, including 48 patients (63%) with liver malignancy and 28 patients with non-malignant liver diseases (37%). We initiated the program of robotic liver resection since the beginning of 2012, and finished 350 robotic liver resection in the past 6 years, including 26 living donor of liver harvested by robotic approach.
We got increased percentage of major liver resection from 15% to 33% with the assistance of robotic system. We successfully performed 26 living donor harvest procedures by robotic minimal invasive approach, including 24 right lobes and 2 left lobe. We got smaller surgical wound over the suprapubic area (8~10 cm), shorter hospital stay (6 days after operation), less postoperative pain, but longer operation time (8 hours).
The previous experience of laparoscopic liver resection helps us to get used and handle this high technique robotic system quickly. The consistency, flexibility and three-dimentional vision of this robotic system are the potential benefits for minimal invasive liver resection in our preliminary experience. The established technique for liver harvest from living donor by robotic approach will increase the percentage of minimal invasive surgery for living donor which will get the advantage of donor safety.