title: Totally robotic right hepatectomy: surgical technique and outcomes.
abstract: OBJECTIVE
  Robotic surgery for performance of right hepatectomy is safe and effective.
  
  
  METHODS
  Case series from 2 medical institutions.
  
  
  METHODS
  University of Illinois at Chicago and Misericordia Hospital, Grosseto, Italy.
  
  
  METHODS
  Twenty-four patients underwent right hepatectomy between March 1, 2005, and January 31, 2010, using a robotic surgical system.
  
  
  METHODS
  Intraoperative blood loss, operative time, morbidity, mortality, and long-term oncologic follow-up.
  
  
  RESULTS
  The procedure was converted to open surgery in 1 patient (4.2%). The overall mean (SD) operative time was 337 (65) minutes (range, 240-480 minutes), and the mean (SD) intraoperative blood loss was 457 (401) mL (range, 100-2000 mL). Three patients (12.5%) underwent blood transfusion. There were no perioperative deaths and no reoperations. Six patients (25.0%) experienced postoperative morbidity, including transitory liver failure in 2 patients and pleural effusion, bile leak, fluid collection, and deep venous thrombosis in 1 patient each. The patients' diagnoses included colorectal liver metastases (n = 11), noncolorectal liver metastases (n = 4), hemangioma (n = 4), adenoma (n = 2), hepatocellular carcinoma (n = 1), hepatoblastoma (n = 1), and biliary amartoma (n = 1). At a mean follow-up duration of 34 months, no port site metastases were observed in patients with malignant pathologic findings.
  
  
  CONCLUSIONS
  The zero mortality and acceptable morbidity of our series indicate that in experienced hands, robotic right hepatectomy is feasible and safe. Robotic surgery offers a new technical option for minimally invasive major hepatic resections. Long-term results seem to confirm oncologic effectiveness of the procedure.
authors.affiliation: Division of General, Minimally Invasive and Robotic Surgery, Department of Surgery, University of Illinois at Chicago, Chicago, IL 60612, USA. piercg@uic.edu
authors.forename: Pier Cristoforo
authors.initials: PC
authors.lastname: Giulianotti
authors.forename: Fabio
authors.initials: F
authors.lastname: Sbrana
authors.forename: Andrea
authors.initials: A
authors.lastname: Coratti
authors.forename: Francesco Maria
authors.initials: FM
authors.lastname: Bianco
authors.forename: Pietro
authors.initials: P
authors.lastname: Addeo
authors.forename: Nicolas Christian
authors.initials: NC
authors.lastname: Buchs
authors.forename: Subhashini M
authors.initials: SM
authors.lastname: Ayloo
authors.forename: Enrico
authors.initials: E
authors.lastname: Benedetti
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D008107:Liver Diseases / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012371:Robotics / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult