Open, Laparoscopic and Robotic Hepatic Transection: Tools and Methods

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Open, Laparoscopic and Robotic Hepatic Transection: Tools and Methods

Sign in to Purchase Instantly. Overview Bleeding from the liver surface during hepatic transection is one of the main factors affecting mortality and morbidity of liver resection. Product Details Table of Contents. Show More.

Laparoscopic resection of liver tumors

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Robotic Right Hepatectomy by badctoworlculhunt.tk

Loco-regional anesthesia offers evident advantages in almost all branches of surgery since it couples perfectanesthesia Loco-regional anesthesia offers evident advantages in almost all branches of surgery since it couples perfectanesthesia with prolonged postoperative analgesia. Furthermore, new drugs and techniques are ensuring constant progress, and in the past decade the advent of ultrasound-guided regional anesthesia has This book provides a comprehensive and up-to-date overview of the continuously evolving field of dual-energy An introductory section presents information on the physical and technical background of DECT and considers nonspecific and specific software advantages.

Clinical applications of Between and , four systematic reviews and meta-analyses were published comparing outcomes between robotic-assisted versus laparoscopic hepatectomy for liver tumors. However, the robotic resections had longer operative time, increased intraoperative blood loss, and greater cost.

Table of contents

One study reported a lower conversion rate to an open procedure with the robotic approach, 8 and another review suggested potential advantages of enabling performance of more complicated minimally invasive liver resections through use of robotic surgery. The data available are certainly limited, and no definite conclusions regarding the efficacy of robotic versus laparoscopic hepatectomy can be drawn.

However, based on the findings that are available, the literature has shown the two minimally invasive surgery platforms have similar outcomes, with robotic-assisted procedures having a higher cost but possibly enabling surgeons to perform more complex liver resections. Whether it should be considered a tool or a specialized practice, robotic surgery is here to stay, and the importance of credentialing and proper training for surgeons who want to perform robotic liver resections cannot be overstressed. For now, this platform will continue to coexist with laparoscopy as a minimally invasive option.

Robotic hepatic surgery is on a par with laparoscopic hepatectomy in terms of safety, feasibility, and oncologic outcomes and may have some advantages in terms of more advanced procedures. At present, almost 3, da Vinci Surgical Systems are in use in the U. The benefits of a minimally invasive surgical approach for hepatic neoplasms are clear, and if it can be done with no impairment in oncologic outcomes, the choice is straightforward.

Whether surgeons choose a laparoscopic versus robotic approach will depend on their training, experience, and hospital robotic surgery resources. To clarify the role of laparoscopic and robotic surgery for hepatic neoplasms, prospective clinical trials are a consideration. They have been performed to evaluate the role of minimally invasive surgery, with the most notable example being the Clinical Outcomes of Surgical Therapy COST trial examining results of laparoscopic versus open colectomy for cancer showing equivalent outcomes and establishing laparoscopic colectomy as an acceptable alternative to open surgery.


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The American College of Surgeons Oncology Group ACOSOG Z trial compared open versus laparoscopic surgery for rectal cancer and reported laparoscopic resection did not meet criteria for non-inferiority to the open approach. New technologies have learning curves, further complicating the ability to evaluate in randomized trials. Going forward, surgeons who perform minimally invasive liver resection need to be aware of their own capabilities, critically follow their outcomes, and apply best practice guidelines based on available evidence in treating their patients with hepatic malignancies. Tagged as: clinical trials , laparoscopic surgery , robotic surgery.

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Bulletin of the American College of Surgeons N. Saint Clair St. Chicago, IL Contents An area needing further research Prospective clinical trials.


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Figure 1. Robotic liver resection The Second International Consensus Conference on Laparoscopic Liver Resection took place in in Japan in an effort to better define the role of laparoscopic liver resection and to develop internationally accepted guidelines, such as indications for this approach, parenchymal transection methods, and bleeding control. Prospective clinical trials The benefits of a minimally invasive surgical approach for hepatic neoplasms are clear, and if it can be done with no impairment in oncologic outcomes, the choice is straightforward.


  1. Ma il mito sono io: Storia delle storie di Lucia Sarzi: il teatro, la Resistenza, la famiglia Cervi (Italian Edition).
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  5. Nos. 16 & 17: Valse allemande /Paganini.
  6. Recommendations for laparoscopic liver resection: A report from the second international consensus conference held in Morioka. Ann Surg.

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