Robotic fenestration of massive liver cysts using EndoWrist technology

Int J Med Robot. 2019 Aug;15(4):e1994. doi: 10.1002/rcs.1994. Epub 2019 Apr 17.

Abstract

Background: We present the short-term outcomes of robotic fenestration of symptomatic liver cysts using the EndoWrist One Vessel Sealer.

Methods: Data from patients who underwent robotic deroofing were collected and analysed retrospectively.

Results: A total of 17 patients were treated. Mean cyst size was 14 cm (median 15 cm, range 6.3-24). Seven cysts were in posterosuperior or central segments. There were no mortalities or conversions. Blood loss was minimal in all but one case of 200 ml. Mean operating time was 174 minutes (median 170 min, range 97-335). Mean hospital stay was 2.5 days (median 2 days, range 1-10). One patient developed a bile leak requiring ERCP. There are no recurrences with a median follow-up of 19 months.

Conclusion: Robotic fenestration can be safely performed and offers distinct advantages over the laparoscopic approach in the treatment of posterosuperior and perihilar cysts at the expense of longer operating times and increased cost.

Keywords: cholecystectomy; gastrointestinal; general surgery; hepatic cysts; hepatobiliary; human-machine interfaces; laparoscopy; liver; minimal invasive surgery; safety; training.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Cysts / surgery*
  • Ergonomics
  • Female
  • Humans
  • Laparoscopy
  • Length of Stay
  • Liver Diseases / surgery*
  • Male
  • Middle Aged
  • Operative Time
  • Patient Safety
  • Retrospective Studies
  • Robotic Surgical Procedures / instrumentation*
  • Ultrasonography

Supplementary concepts

  • Polycystic liver disease