Introduction of day-case robotic liver surgery: a case series from a tertiary hepatobiliary and pancreatic centre.
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Embargo End Date
ICR Authors
Authors
Yeung, KTD
Vellaisamy, R
Hussain, A
Mingo, O
Raobaikady, R
Nicol, D
Rasheed, S
Tekkis, P
Cunningham, D
Jiao, LR
Vellaisamy, R
Hussain, A
Mingo, O
Raobaikady, R
Nicol, D
Rasheed, S
Tekkis, P
Cunningham, D
Jiao, LR
Document Type
Journal Article
Date
2024-08-01
Date Accepted
2024-05-05
Abstract
BACKGROUND: Liver surgery is associated with a significant hospital stay regardless the type of liver resection. A large incision is essential for open liver surgery which is a major factor in the course of the patient's recovery. For patients with small parenchyma liver lesions requiring surgical resection, robotic surgery potentially offers the opportunity to transform the patient's post-operative course. A day-case robotic liver resection pathway was formulated and implemented at our institution when patients were planned for discharge within 24 h of admission for liver surgery. METHODS: Single surgeon case series of cases performed at a tertiary hepatobiliary and pancreatic centre between September 2022 and November 2023. The inclusion criteria were non-anatomical wedge resections, < 2 anatomical segmental resections, left lateral hepatectomy and minimally invasive surgery. RESULTS: This is the first series of robotic day-case minor liver resection in the United Kingdom. 20 patients were included in this case series. The mean operative time was 86.6 ± 30.9 min and mean console time was 58.6 ± 24.5 min. Thirteen patients (65%) were discharged within 24 h of surgery. The main cause of hospitalisation beyond 24 h was inadequate pain relief. There were no Clavien-Dindo grade III or above complications, no 30-day readmission and 90-day mortalities. CONCLUSION: This case series demonstrates that robotic day-case liver resection is safe and feasible. Robust follow-up pathways must be in place to allow for the safe implementation of this approach, to monitor for any complications and to allow intervention as required in a timely manner.
Citation
Surgical Endoscopy, 2024, 38 (8), pp. 4329 - 4335
Source Title
Surgical Endoscopy
Publisher
SPRINGER
ISSN
0930-2794
eISSN
1432-2218
1432-2218
1432-2218
Collections
Research Team
Medicine (RMH)