Early experiences in robotic single-site plus one port platform for complex hepatobiliary and pancreatic surgery

Int J Med Robot. 2023 Dec 16:e2602. doi: 10.1002/rcs.2602. Online ahead of print.

Abstract

Background: Minimal invasive surgery in hepatobiliary and pancreatic (HBP) surgery has been accepted worldwide in recent years. However, applications of single-site laparoscopic surgery in complex HBP surgery have been limited due to difficulty in manoeuvring instruments and the limited range of motion resulting from clashing instruments.

Methods: To overcome the limitations, we have used the Da Vinci single-site surgical platform with one additional port in a Da Vinci Xi system to perform donor right hepatectomy, pancreaticoduodenectomy, and combined resection of the common bile duct and spleen vessels preserving distal pancreatectomy.

Results: In selected patients, using a robotic single-site plus one port system allowed the successful completion of complex HBP surgery.

Discussion: Complex HBP surgery can be performed safely in a stable environment using the robotic single-site plus one port system. Further exploration of a robotic single-site plus one port in complex HBP surgery is necessary.

Keywords: distal pancreatectomy; donor hepatectomy; minimally invasive surgery; pancreaticoduodenectomy; single-site surgery.