title: Robotic hepatectomy: initial experience of a single institution in Singapore.
abstract: BACKGROUND
  In this study, we report our initial experience with robotic hepatectomy.
  
  
  METHODS
  Consecutive patients who underwent robotic hepatectomy at Singapore General Hospital, Singapore, from February 2013 to February 2015 were enrolled in this study. The difficulty level of operations was graded using a novel scoring system for laparoscopic hepatectomies.
  
  
  RESULTS
  During the two-year period, five consecutive robotic hepatectomies were performed (one left lateral sectionectomy, one non-anatomical segment II/III resection, one anatomical segment V resection with cholecystectomy, one extended right posterior sectionectomy and one non-anatomical segment V/VI resection). Two hepatectomies were performed for suspected hepatocellular carcinoma, two for solitary liver metastases and one for a large symptomatic haemangioma. The median age of the patients was 53 (range 38-66) years and the median tumour size was 2.5 (range 2.1-7.3) cm. The median total operation time was 340 (range 155-825) minutes and the median volume of blood loss was 300 (range 50-1,200) mL. There were no open conversions and no mortalities or major morbidities (> Clavien-Dindo Grade II). The difficulty level of the operations was graded as low in one case (Score 2), intermediate in three cases (Score 5, 6 and 6) and high in one case (Score 10). There was one minor morbidity, where the patient experienced Grade A bile leakage, which resolved spontaneously. The median length of postoperative hospital stay was 5 (range 4-7) days.
  
  
  CONCLUSIONS
  Our initial experience confirmed the feasibility and safety of robotic hepatectomy.
authors: Department of Hepatopancreatobiliary and Transplantation Surgery, Singapore General Hospital, Singapore.
authors: Juinn Huar
authors: JH
authors: Kam
authors: Department of Hepatopancreatobiliary and Transplantation Surgery, Singapore General Hospital, Singapore.|Duke-NUS Graduate Medical School, Singapore.
authors: Brian Kp
authors: BK
authors: Goh
authors: Department of Hepatopancreatobiliary and Transplantation Surgery, Singapore General Hospital, Singapore.
authors: Chung-Yip
authors: CY
authors: Chan
authors: Department of Hepatopancreatobiliary and Transplantation Surgery, Singapore General Hospital, Singapore.
authors: Jen-San
authors: JS
authors: Wong
authors: Department of Hepatopancreatobiliary and Transplantation Surgery, Singapore General Hospital, Singapore.
authors: Ser-Yee
authors: SY
authors: Lee
authors: Department of Hepatopancreatobiliary and Transplantation Surgery, Singapore General Hospital, Singapore.
authors: Peng-Chung
authors: PC
authors: Cheow
authors: Department of Hepatopancreatobiliary and Transplantation Surgery, Singapore General Hospital, Singapore.
authors: Alexander Y F
authors: AY
authors: Chung
authors: Department of Hepatopancreatobiliary and Transplantation Surgery, Singapore General Hospital, Singapore.|Duke-NUS Graduate Medical School, Singapore.
authors: London L P J
authors: LL
authors: Ooi
mesh_terms: D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay; D008113:Liver Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D061646:Operative Time; D011446:Prospective Studies; D012371:Robotics; D012846:Singapore
keywords: laparoscopic hepatectomy; laparoscopic liver resection; minimally invasive hepatectomy; robotic hepatectomy; robotic liver resection