Manual and Robotic Laparoscopic Liver Resection. Two Case-Reviews

Overview

Introduction:
Laparoscopic resection of the liver, compared to other laparoscopic procedures of the abdominal cavity, have become used in a clinical practice only in recent years. No literature data on robotic liver resections are available.

Methods:
The authors completed 2 laparoscopic resections of the liver. The first case included a 61-year old male indicated for the procedure with a low differenciated hepatocellular carcinoma lesion in SII and SIII segments, measuring 6 cm in a diameter, in a Child A cirrhotic remodellation terrain. In-line RFA-assisted and HandPort- assisted manual laparoscopic leftsided lobectomy was completed. Histological findings confirmed the diagnosis and the R0 resection. Robotic laparoscopic resection of the focal nodular hyperplasia (FNH) lesion, growing from SII and SIII segments and measuring 7×7×5 cm was completed in the other case of a 29-year old female patient.

Results and Conclusion:
Both patients healed without complications, the hospitalization lasted 8 and 7 days, respectively. HandPort-assissted manual laparoscopic resections of the left liver lobe appears a safe method. The patient may benefit from a smaller entrance into the abdominal cavity, compared with open abdominal procedures. Experience in liver and laparoscopic surgery is a prerequisite, which is also supported by literature data. A pilot study must be conducted in order to assess benefits of robotic laparoscopic liver resections.

Key words:
liver surgery – manual laparoscopic resection of the liver – robotic laparoscopic resection of the liver – da Vinci robotic system