title: Robotic assisted Roux-en-Y hepaticojejunostomy in a post-cholecystectomy type E2 bile duct injury.
abstract: Roux-en-Y hepaticojejunostomy anastomosis is the treatment of choice for common hepatic duct injury type E2. It has been performed laparoscopically with the advancement of laparoscopic skill. Recently, a telemanipulative robotic surgical system was introduced, providing laparoscopic instruments with wrist-arm technology and 3-dimensional visualization of the operative field. We present a case of 36-year-old female patient who had undergone elective cholecystectomy 2 mo ago for gall stones and had a common bile duct injury during surgery. As the stricture was old and complete it could not be tackled endoscopically. We did a laparoscopic assisted adhesiolysis followed by robotic Roux-en-Y hepaticojejunostomy. No intraoperative complications or technical problems were encountered. Postoperative period was uneventful and she was discharged on the 4th postoperative day. At follow-up, she is doing well without evidence of jaundice or cholangitis. This is the first reported case of robotic hepaticojejunostomy following common bile duct injury. The hybrid technique gives the patient benefit of laparoscopic adhesiolysis and robotic suturing.
authors: Arun Prasad, Sudipto De, Purak Mishra, Abhishek Tiwari, Department of Minimal Access and Robotic Surgery, Apollo Hospital, New Delhi 110076, India.
authors: Arun
authors: A
authors: Prasad
authors: Arun Prasad, Sudipto De, Purak Mishra, Abhishek Tiwari, Department of Minimal Access and Robotic Surgery, Apollo Hospital, New Delhi 110076, India.
authors: Sudipto
authors: S
authors: De
authors: Arun Prasad, Sudipto De, Purak Mishra, Abhishek Tiwari, Department of Minimal Access and Robotic Surgery, Apollo Hospital, New Delhi 110076, India.
authors: Purak
authors: P
authors: Mishra
authors: Arun Prasad, Sudipto De, Purak Mishra, Abhishek Tiwari, Department of Minimal Access and Robotic Surgery, Apollo Hospital, New Delhi 110076, India.
authors: Abhishek
authors: A
authors: Tiwari
mesh_terms: D000328:Adult; D000713:Anastomosis, Roux-en-Y; D001652:Bile Ducts / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery*; D001662:Biliary Tract Surgical Procedures / Q000295:instrumentation / Q000379:methods*; D049448:Cholangiopancreatography, Magnetic Resonance; D002763:Cholecystectomy / Q000009:adverse effects*; D004867:Equipment Design; D005260:Female; D006801:Humans; D007049:Iatrogenic Disease; D007582:Jejunostomy / Q000295:instrumentation / Q000379:methods*; D010535:Laparoscopy; D065287:Robotic Surgical Procedures / Q000295:instrumentation / Q000379:methods*; D013523:Surgical Equipment; D013536:Suture Techniques; D016896:Treatment Outcome; D014463:Ultrasonography
keywords: Cholecystectomy complication; Common bile duct; Hepatic duct; Hepaticojejunostomy; Robotic surgery