title: Simultaneous Retroperitoneal Robotic Partial Nephrectomy and Hepatectomy for Synchronous Renal-Cell Carcinoma and Hepatocellular Carcinoma in a Cirrhotic Patient.
abstract: Background:The development of laparoscopic and robotic surgeries represents the modern era with the objective of improving patient outcomes; this surgical method is widespread in urology and general surgery. Retroperitoneal laparoscopic/robotic surgery is common in urologic surgery, but not in liver surgery. Tumors located in the posterosuperior aspect of the liver are difficult to access using a transperitoneal approach, and control of bleeding can also be difficult, especially in patients with cirrhosis.Case Presentation:Herein, we present a 66-year-old man who had a cirrhotic liver with concurrent renal and hepatic tumors. The renal tumor was located at the upper pole of the right kidney and the liver tumor was located at the liver dome (segment VII); the patient underwent simultaneous robotic hepatectomy and partial nephrectomy with a retroperitoneal approach.Conclusion:To our knowledge, this is the first case involving a retroperitoneal approach for a simultaneous robotic hepatectomy and partial nephrectomy; this method was feasible and safe. We hope this approach serves as an alternative surgical method for patients with synchronous renal and posterior segment liver tumors.
authors.affiliation: Division of Gastroenterology & General Surgery, Department of Surgery, Chi Mei Medical Center , Tainan, Taiwan .
authors.forename: Khaa Hoo
authors.initials: KH
authors.lastname: Ong
authors.affiliation: Division of Urological Oncology, Department of Surgery, Chi Mei Medical Center, Tainan, Taiwan.; Chai Nan University of Pharmacy and Science, Tainan, Taiwan.
authors.forename: Steven Kuan-Hua
authors.initials: SK
authors.lastname: Huang
authors.affiliation: Division of Gastroenterology & General Surgery, Department of Surgery, Chi Mei Medical Center , Tainan, Taiwan .
authors.forename: Chia-Sheng
authors.initials: CS
authors.lastname: Yen
authors.affiliation: Division of Gastroenterology & General Surgery, Department of Surgery, Chi Mei Medical Center, Tainan, Taiwan.; Chai Nan University of Pharmacy and Science, Tainan, Taiwan.
authors.forename: Yu-Feng
authors.initials: YF
authors.lastname: Tian
authors.affiliation: Division of Gastroenterology & General Surgery, Department of Surgery, Chi Mei Medical Center, Tainan, Taiwan.; Chai Nan University of Pharmacy and Science, Tainan, Taiwan.
authors.forename: Ding-Ping
authors.initials: DP
authors.lastname: Sun
keywords: hepatectomy; partial nephrectomy; retroperitoneal; robotic surgery; simultaneous