Robotic right hepatectomy for giant hemangioma in a Jehovah's Witness.
OBJECTIVE
The use of minimally invasive surgery for the resection of benign liver tumors has increased in recent years as results show decreased abdominal damage and significant cosmetic advantages. Herein, we describe the first reported application of minimally invasive surgery for the removal of a giant symptomatic hemangioma, using robotic surgery, in a Jehovah's Witness (JW) patient.


METHODS
A 32-year-old JW presented with abdominal discomfort and recent episodes of acute abdominal pain due to a giant cavernous hemangioma involving segments VI and VII of the liver. Because of the location and size of the lesion, a right hepatectomy was planned. After a careful preoperative evaluation, a robotic right hepatectomy was performed using the da Vinci Surgical System.


RESULTS
The procedure was successfully completed in minimally invasive fashion with an operative time of 310 min and with an intraoperative blood loss of only 300 ml. The postoperative course was uneventful and the patient was discharged on postoperative day 10. At 30-month follow up the patient reported complete relief of symptoms and good esthetic results.


CONCLUSIONS
In experienced hands, a minimally invasive robotic major hepatic resection is a viable option that can be performed with minimal blood loss in a JW patient. A careful preoperative and intraoperative strategy is required and significant experience in liver and robotic surgery is mandatory.
Giulianotti
Pier Cristoforo
PC
Division of General, Minimally Invasive and Robotic Surgery, Department of Surgery, University of Illinois at Chicago, 840 S Wood Street, Suite 435 E, Chicago, IL 60612, USA. piercg@uic.edu
Addeo
Pietro
P
Bianco
Francesco Maria
FM
D000328:Adult; D003287:Contrast Media; D005260:Female; D006391:Hemangioma / Q000175:diagnosis / Q000601:surgery*; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D033221:Jehovah's Witnesses; D010535:Laparoscopy / Q000379:methods*; D008113:Liver Neoplasms / Q000175:diagnosis / Q000601:surgery*; D008279:Magnetic Resonance Imaging; D012371:Robotics
D003287:Contrast Media