Asian journal of endoscopic surgery · 2026
Standardization and Learning Curve of Robotic Left Hepatectomy Employing Glissonean Approach.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Umemura Akira, Nitta Hiroyuki, Kikuchi Koji, Takeda Daiki, Ando Taro, Kawashima Toma, Amano Satoshi, Kimura Taku, Sasaki Akira
Аннотация
BACKGROUND: Robotic liver resection (RLR) is widely performed as an alternative to laparoscopic liver resection. Many different surgical robot systems (SRSs) have been developed; however, there are relatively few standardized RLR procedures that can be applied to the use of different SRSs. We present a standardized robotic left hepatectomy (RLH) procedure for different SRSs and the learning curve derived via cumulative sum analysis.
MATERIALS AND SURGICAL TECHNIQUE: We performed 14 cases of RLH using our standardized procedure. We mobilized the left lobe, and the round ligament was drawn to the caudal side. The omental bursa is opened, and the Arantius duct is carefully transected. The left Glissonean pedicle was encircled and transected using a linear stapler after confirming the demarcation line. Parenchymal transection is gently performed using the clamp-crush technique (intermittent Pringle's maneuver). The root of the left hepatic vein was visualized at the end of the parenchymal transection, and this vein was transected using a linear stapler.
DISCUSSION: In our series, there were no intraoperative transfusions or conversions. One case of bile leakage required endoscopic treatment, and the patient survived. The learning curve plateaued at seven cases of RLH. Our standardized RLH procedure, which includes the Glissonean approach and the clamp-crush method, can be applied to all SRSs without any specific energy devices.
MATERIALS AND SURGICAL TECHNIQUE: We performed 14 cases of RLH using our standardized procedure. We mobilized the left lobe, and the round ligament was drawn to the caudal side. The omental bursa is opened, and the Arantius duct is carefully transected. The left Glissonean pedicle was encircled and transected using a linear stapler after confirming the demarcation line. Parenchymal transection is gently performed using the clamp-crush technique (intermittent Pringle's maneuver). The root of the left hepatic vein was visualized at the end of the parenchymal transection, and this vein was transected using a linear stapler.
DISCUSSION: In our series, there were no intraoperative transfusions or conversions. One case of bile leakage required endoscopic treatment, and the patient survived. The learning curve plateaued at seven cases of RLH. Our standardized RLH procedure, which includes the Glissonean approach and the clamp-crush method, can be applied to all SRSs without any specific energy devices.