title: Laparoscopic robotic liver surgery: the Henri Mondor initial experience of 20 cases.
abstract: Laparoscopic liver surgery is now an established practice in many institutions. It is a safe and feasible approach in the hands of trained surgeons. The introduction of robotics into surgery represents progression in the field of minimally invasive surgery but has seen a slow uptake in the hepatopancreaticobiliary subspeciality. We report our initial experience in 20 cases of laparoscopic robotic liver resection (LRLR). From March 2011 to April 2013 patients with lesions within the liver were assessed and consented for laparoscopic robotic liver surgery. This is a retrospective analysis of a prospectively kept database on preoperative details and intraoperative and postoperative outcomes. During the time period there were 20 LRLRs. The median age was 62 years (range 39-80 years) with a male to female ratio of 14:6. Ten patients had left lateral sectionectomies, 10 patients had atypical segmental resections; 14 patients had resections for malignancies, 6 patients had resections for benign disease. One case was converted to open resection. The mean operating time was 176.4 ± 74.6 min (range 60-300 min), the mean blood loss was 107 ± 106 ml (range 50-700 ml) and the mean hospital stay was 6.5 ± 3.7 days (range 2-16 days). Two patients required blood transfusions. The incidence of postoperative complications was 10 % (n = 2). LRLR overcomes some of the disadvantages of conventional laparoscopic surgery. It is a technically feasible and safe approach for wedge resections and left lateral sectionectomy of the liver without oncological compromise. However, this surgical technique requires advanced laparoscopic skills and there is an associated steep learning curve. Further studies are needed to determine the potential advantages of this technique for the patient compared to the traditional laparoscopic approach.
authors.affiliation: Service Chirurgie Digestive, Hépato-Bilio-Pancréatique et Transplantation Hépatique Hôpital Henri Mondor, 51 avenue De Lattre De Tassigny, 94010, Créteil, France.
authors.forename: Chady
authors.initials: C
authors.lastname: Salloum
authors.affiliation: Service Chirurgie Digestive, Hépato-Bilio-Pancréatique et Transplantation Hépatique Hôpital Henri Mondor, 51 avenue De Lattre De Tassigny, 94010, Créteil, France.|Department of General and HPB Surgery, Blackburn Royal Hospital, Haslingden Road, Blackburn, Lancashire, BB2 3HH, UK.
authors.forename: Daren
authors.initials: D
authors.lastname: Subar
authors.affiliation: Service Chirurgie Digestive, Hépato-Bilio-Pancréatique et Transplantation Hépatique Hôpital Henri Mondor, 51 avenue De Lattre De Tassigny, 94010, Créteil, France. drmemeo@yahoo.it.
authors.forename: Riccardo
authors.initials: R
authors.lastname: Memeo
authors.affiliation: Service Chirurgie Digestive, Hépato-Bilio-Pancréatique et Transplantation Hépatique Hôpital Henri Mondor, 51 avenue De Lattre De Tassigny, 94010, Créteil, France.
authors.forename: Claude
authors.initials: C
authors.lastname: Tayar
authors.affiliation: Service Chirurgie Digestive, Hépato-Bilio-Pancréatique et Transplantation Hépatique Hôpital Henri Mondor, 51 avenue De Lattre De Tassigny, 94010, Créteil, France.
authors.forename: Alexis
authors.initials: A
authors.lastname: Laurent
authors.affiliation: Service Chirurgie Digestive, Hépato-Bilio-Pancréatique et Transplantation Hépatique Hôpital Henri Mondor, 51 avenue De Lattre De Tassigny, 94010, Créteil, France.
authors.forename: Alexandre
authors.initials: A
authors.lastname: Malek
authors.affiliation: Service Chirurgie Digestive, Hépato-Bilio-Pancréatique et Transplantation Hépatique Hôpital Henri Mondor, 51 avenue De Lattre De Tassigny, 94010, Créteil, France.
authors.forename: Daniel
authors.initials: D
authors.lastname: Azoulay
keywords: Laparoscopic; Liver resection; Robotic liver resection; Technique