Skip to main content
Erschienen in: Surgical Endoscopy 10/2018

27.08.2018

Intraoperative ultrasonography of robot-assisted laparoscopic hepatectomy: initial experiences from 110 consecutive cases

verfasst von: Peng Zhu, Wei Liao, Ze-yang Ding, Hong-chang Luo, Bin-hao Zhang, Wan-guang Zhang, Wei Zhang, Zhan-guo Zhang, Bi-xiang Zhang, Xiao-ping Chen

Erschienen in: Surgical Endoscopy | Ausgabe 10/2018

Einloggen, um Zugang zu erhalten

Abstract

Background

To evaluate the safety and efficacy of IOUS in robotic liver surgery and propose a standard protocol of IOUS for safe robot-assisted hepatectomy.

Methods

Between February 2015 and December 2016, liver resection was performed in 110 patients with robotic approach in Tongji Hospital. In these patients, IOUS was routinely performed. All data about demographic, surgical procedure, postoperative course were collected prospectively and analyzed.

Results

A four steps IOUS protocol in robotic liver surgery was proposed, including exploration, verification, guidance, and confirmation. A total of 11 additional lesions in 11 patients were detected and 7 patients accepted strategic surgical modification. No patient suffered from any single or multiple organ dysfunctions, and there were no mortalities observed.

Conclusion

IOUS is indispensable to understand lesions and vessels in robotic liver surgery. A four-step standard protocol of IOUS is essential for safe robot-assisted hepatectomy.
Literatur
1.
Zurück zum Zitat Tranchart H, Ceribelli C, Ferretti S, Dagher I, Patriti A (2014) Traditional versus robot-assisted full laparoscopic liver resection: a matched-pair comparative study. World J Surg 38:2904–2909CrossRef Tranchart H, Ceribelli C, Ferretti S, Dagher I, Patriti A (2014) Traditional versus robot-assisted full laparoscopic liver resection: a matched-pair comparative study. World J Surg 38:2904–2909CrossRef
2.
Zurück zum Zitat Vigano L, Laurent A, Tayar C, Tomatis M, Ponti A, Cherqui D (2009) The learning curve in laparoscopic liver resection: improved feasibility and reproducibility. Ann Surg 250:772–782CrossRef Vigano L, Laurent A, Tayar C, Tomatis M, Ponti A, Cherqui D (2009) The learning curve in laparoscopic liver resection: improved feasibility and reproducibility. Ann Surg 250:772–782CrossRef
3.
Zurück zum Zitat Ishizawa T, Gumbs AA, Kokudo N, Gayet B (2012) Laparoscopic segmentectomy of the liver: from segment I to VIII. Ann Surg 256:959–964CrossRef Ishizawa T, Gumbs AA, Kokudo N, Gayet B (2012) Laparoscopic segmentectomy of the liver: from segment I to VIII. Ann Surg 256:959–964CrossRef
4.
Zurück zum Zitat Coelho FF (2016) Laparoscopic liver resection: experience based guidelines. World J Gastrointest Surg 8:5CrossRef Coelho FF (2016) Laparoscopic liver resection: experience based guidelines. World J Gastrointest Surg 8:5CrossRef
5.
Zurück zum Zitat Mostaedi R, Milosevic Z, Han HS, Khatri VP (2012) Laparoscopic liver resection: current role and limitations. World J Gastrointest Oncol 4:187–192CrossRef Mostaedi R, Milosevic Z, Han HS, Khatri VP (2012) Laparoscopic liver resection: current role and limitations. World J Gastrointest Oncol 4:187–192CrossRef
6.
Zurück zum Zitat Han HS, Shehta A, Ahn S, Yoon YS, Cho JY, Choi Y (2015) Laparoscopic versus open liver resection for hepatocellular carcinoma: case-matched study with propensity score matching. J Hepatol 63:643–650CrossRef Han HS, Shehta A, Ahn S, Yoon YS, Cho JY, Choi Y (2015) Laparoscopic versus open liver resection for hepatocellular carcinoma: case-matched study with propensity score matching. J Hepatol 63:643–650CrossRef
7.
Zurück zum Zitat Qiu J, Chen S, Chengyou D (2016) A systematic review of robotic-assisted liver resection and meta-analysis of robotic versus laparoscopic hepatectomy for hepatic neoplasms. Surg Endosc 30:862–875CrossRef Qiu J, Chen S, Chengyou D (2016) A systematic review of robotic-assisted liver resection and meta-analysis of robotic versus laparoscopic hepatectomy for hepatic neoplasms. Surg Endosc 30:862–875CrossRef
8.
Zurück zum Zitat Pelletier JS, Gill RS, Shi X, Birch DW, Karmali S (2013) Robotic-assisted hepatic resection: a systematic review. Int J Med Robot Comput Assisted Surg 9:262–267CrossRef Pelletier JS, Gill RS, Shi X, Birch DW, Karmali S (2013) Robotic-assisted hepatic resection: a systematic review. Int J Med Robot Comput Assisted Surg 9:262–267CrossRef
9.
Zurück zum Zitat Buell JF, Cherqui D, Geller DA, O’Rourke N, Iannitti D, Dagher I, Koffron AJ, Thomas M, Gayet B, Han HS, Wakabayashi G, Belli G, Kaneko H, Ker CG, Scatton O, Laurent A, Abdalla EK, Chaudhury P, Dutson E, Gamblin C, D’Angelica M, Nagorney D, Testa G, Labow D, Manas D, Poon RT, Nelson H, Martin R, Clary B, Pinson WC, Martinie J, Vauthey JN, Goldstein R, Roayaie S, Barlet D, Espat J, Abecassis M, Rees M, Fong Y, McMasters KM, Broelsch C, Busuttil R, Belghiti J, Strasberg S, Chari RS, World Consensus Conference on Laparoscopic S (2009) The international position on laparoscopic liver surgery: the Louisville Statement, 2008. Ann Surg 250:825–830CrossRef Buell JF, Cherqui D, Geller DA, O’Rourke N, Iannitti D, Dagher I, Koffron AJ, Thomas M, Gayet B, Han HS, Wakabayashi G, Belli G, Kaneko H, Ker CG, Scatton O, Laurent A, Abdalla EK, Chaudhury P, Dutson E, Gamblin C, D’Angelica M, Nagorney D, Testa G, Labow D, Manas D, Poon RT, Nelson H, Martin R, Clary B, Pinson WC, Martinie J, Vauthey JN, Goldstein R, Roayaie S, Barlet D, Espat J, Abecassis M, Rees M, Fong Y, McMasters KM, Broelsch C, Busuttil R, Belghiti J, Strasberg S, Chari RS, World Consensus Conference on Laparoscopic S (2009) The international position on laparoscopic liver surgery: the Louisville Statement, 2008. Ann Surg 250:825–830CrossRef
10.
Zurück zum Zitat Wakabayashi G, Cherqui D, Geller DA, Buell JF, Kaneko H, Han HS, Asbun H, O’Rourke N, Tanabe M, Koffron AJ, Tsung A, Soubrane O, Machado MA, Gayet B, Troisi RI, Pessaux P, Van Dam RM, Scatton O, Abu Hilal M, Belli G, Kwon CH, Edwin B, Choi GH, Aldrighetti LA, Cai X, Cleary S, Chen KH, Schon MR, Sugioka A, Tang CN, Herman P, Pekolj J, Chen XP, Dagher I, Jarnagin W, Yamamoto M, Strong R, Jagannath P, Lo CM, Clavien PA, Kokudo N, Barkun J, Strasberg SM (2015) Recommendations for laparoscopic liver resection: a report from the second international consensus conference held in Morioka. Ann Surg 261:619–629PubMed Wakabayashi G, Cherqui D, Geller DA, Buell JF, Kaneko H, Han HS, Asbun H, O’Rourke N, Tanabe M, Koffron AJ, Tsung A, Soubrane O, Machado MA, Gayet B, Troisi RI, Pessaux P, Van Dam RM, Scatton O, Abu Hilal M, Belli G, Kwon CH, Edwin B, Choi GH, Aldrighetti LA, Cai X, Cleary S, Chen KH, Schon MR, Sugioka A, Tang CN, Herman P, Pekolj J, Chen XP, Dagher I, Jarnagin W, Yamamoto M, Strong R, Jagannath P, Lo CM, Clavien PA, Kokudo N, Barkun J, Strasberg SM (2015) Recommendations for laparoscopic liver resection: a report from the second international consensus conference held in Morioka. Ann Surg 261:619–629PubMed
11.
Zurück zum Zitat Lai EC, Yang GP, Tang CN (2013) Robot-assisted laparoscopic liver resection for hepatocellular carcinoma: short-term outcome. Am J Surg 205:697–702CrossRef Lai EC, Yang GP, Tang CN (2013) Robot-assisted laparoscopic liver resection for hepatocellular carcinoma: short-term outcome. Am J Surg 205:697–702CrossRef
12.
Zurück zum Zitat Makuuchi M, Hasegawa H, Yamazaki S (1985) Ultrasonically guided subsegmentectomy. Surg Gynecol Obstetric 161:346–350 Makuuchi M, Hasegawa H, Yamazaki S (1985) Ultrasonically guided subsegmentectomy. Surg Gynecol Obstetric 161:346–350
13.
Zurück zum Zitat Castaing D, Emond J, Kunstlinger F, Bismuth H (1986) Utility of operative ultrasound in the surgical management of liver tumors. Ann Surg 204:600–605CrossRef Castaing D, Emond J, Kunstlinger F, Bismuth H (1986) Utility of operative ultrasound in the surgical management of liver tumors. Ann Surg 204:600–605CrossRef
14.
Zurück zum Zitat Vigano L, Ferrero A, Amisano M, Russolillo N, Capussotti L (2013) Comparison of laparoscopic and open intraoperative ultrasonography for staging liver tumours. Br J Surg 100:535–542CrossRef Vigano L, Ferrero A, Amisano M, Russolillo N, Capussotti L (2013) Comparison of laparoscopic and open intraoperative ultrasonography for staging liver tumours. Br J Surg 100:535–542CrossRef
15.
Zurück zum Zitat Schneider CM, Peng PD, Taylor RH, Dachs GW 2nd, Hasser CJ, DiMaio SP, Choti MA (2012) Robot-assisted laparoscopic ultrasonography for hepatic surgery. Surgery 151:756–762CrossRef Schneider CM, Peng PD, Taylor RH, Dachs GW 2nd, Hasser CJ, DiMaio SP, Choti MA (2012) Robot-assisted laparoscopic ultrasonography for hepatic surgery. Surgery 151:756–762CrossRef
16.
Zurück zum Zitat Ferrero A, Lo Tesoriere R, Russolillo N, Vigano L, Forchino F, Capussotti L (2015) Ultrasound-guided laparoscopic liver resections. Surg Endosc 29:1002–1005CrossRef Ferrero A, Lo Tesoriere R, Russolillo N, Vigano L, Forchino F, Capussotti L (2015) Ultrasound-guided laparoscopic liver resections. Surg Endosc 29:1002–1005CrossRef
17.
Zurück zum Zitat Dindo D, Demartines N, Clavien PA (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 240:205–213CrossRef Dindo D, Demartines N, Clavien PA (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 240:205–213CrossRef
18.
Zurück zum Zitat Balzan S, Belghiti J, Farges O, Ogata S, Sauvanet A, Delefosse D, Durand F (2005) The “50-50 criteria” on postoperative day 5: an accurate predictor of liver failure and death after hepatectomy. Ann Surg 242:824–828 discussion 828-829 CrossRef Balzan S, Belghiti J, Farges O, Ogata S, Sauvanet A, Delefosse D, Durand F (2005) The “50-50 criteria” on postoperative day 5: an accurate predictor of liver failure and death after hepatectomy. Ann Surg 242:824–828 discussion 828-829 CrossRef
19.
Zurück zum Zitat Araki K, Conrad C, Ogiso S, Kuwano H, Gayet B (2014) Intraoperative ultrasonography of laparoscopic hepatectomy: key technique for safe liver transection. J Am Coll Surg 218:e37–e41CrossRef Araki K, Conrad C, Ogiso S, Kuwano H, Gayet B (2014) Intraoperative ultrasonography of laparoscopic hepatectomy: key technique for safe liver transection. J Am Coll Surg 218:e37–e41CrossRef
20.
Zurück zum Zitat Makuuchi M, Hasegawa H, Yamazaki S, Takayasu K, Moriyama N (1987) The use of operative ultrasound as an aid to liver resection in patients with hepatocellular carcinoma. World J Surg 11:615–621CrossRef Makuuchi M, Hasegawa H, Yamazaki S, Takayasu K, Moriyama N (1987) The use of operative ultrasound as an aid to liver resection in patients with hepatocellular carcinoma. World J Surg 11:615–621CrossRef
21.
Zurück zum Zitat Parker GA, Lawrence W Jr, Horsley JS 3rd, Neifeld JP, Cook D, Walsh J, Brewer W, Koretz MJ (1989) Intraoperative ultrasound of the liver affects operative decision making. Ann Surg 209:569–576 discussion 576–567 CrossRef Parker GA, Lawrence W Jr, Horsley JS 3rd, Neifeld JP, Cook D, Walsh J, Brewer W, Koretz MJ (1989) Intraoperative ultrasound of the liver affects operative decision making. Ann Surg 209:569–576 discussion 576–567 CrossRef
22.
Zurück zum Zitat Ishizawa T, Saiura A, Kokudo N (2016) Clinical application of indocyanine green-fluorescence imaging during hepatectomy. Hepatobiliary Surg Nutr 5:322–328CrossRef Ishizawa T, Saiura A, Kokudo N (2016) Clinical application of indocyanine green-fluorescence imaging during hepatectomy. Hepatobiliary Surg Nutr 5:322–328CrossRef
23.
Zurück zum Zitat Leen E, Ceccotti P, Moug SJ, Glen P, MacQuarrie J, Angerson WJ, Albrecht T, Hohmann J, Oldenburg A, Ritz JP, Horgan PG (2006) Potential value of contrast-enhanced intraoperative ultrasonography during partial hepatectomy for metastases: an essential investigation before resection? Ann Surg 243:236–240CrossRef Leen E, Ceccotti P, Moug SJ, Glen P, MacQuarrie J, Angerson WJ, Albrecht T, Hohmann J, Oldenburg A, Ritz JP, Horgan PG (2006) Potential value of contrast-enhanced intraoperative ultrasonography during partial hepatectomy for metastases: an essential investigation before resection? Ann Surg 243:236–240CrossRef
24.
Zurück zum Zitat Donadon M, Botea F, Del Fabbro D, Palmisano A, Montorsi M, Torzilli G (2008) The surgical policy predicts the impact of contrast enhanced intraoperative ultrasound for colorectal liver metastases. Eur J Radiol 67:177–178CrossRef Donadon M, Botea F, Del Fabbro D, Palmisano A, Montorsi M, Torzilli G (2008) The surgical policy predicts the impact of contrast enhanced intraoperative ultrasound for colorectal liver metastases. Eur J Radiol 67:177–178CrossRef
25.
Zurück zum Zitat Strasberg S, Belghiti J, Clavien P-A, Gadzijev E, Garden J, Lau W-Y, Makuuchi M, Strong R (2000) The Brisbane 2000 terminology of liver anatomy and resections. HPB 2:333–339CrossRef Strasberg S, Belghiti J, Clavien P-A, Gadzijev E, Garden J, Lau W-Y, Makuuchi M, Strong R (2000) The Brisbane 2000 terminology of liver anatomy and resections. HPB 2:333–339CrossRef
Metadaten
Titel
Intraoperative ultrasonography of robot-assisted laparoscopic hepatectomy: initial experiences from 110 consecutive cases
verfasst von
Peng Zhu
Wei Liao
Ze-yang Ding
Hong-chang Luo
Bin-hao Zhang
Wan-guang Zhang
Wei Zhang
Zhan-guo Zhang
Bi-xiang Zhang
Xiao-ping Chen
Publikationsdatum
27.08.2018
Verlag
Springer US
Erschienen in
Surgical Endoscopy / Ausgabe 10/2018
Print ISSN: 0930-2794
Elektronische ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-017-5854-9

Weitere Artikel der Ausgabe 10/2018

Surgical Endoscopy 10/2018 Zur Ausgabe

Update Chirurgie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

S3-Leitlinie „Diagnostik und Therapie des Karpaltunnelsyndroms“

CME: 2 Punkte

Prof. Dr. med. Gregor Antoniadis Das Karpaltunnelsyndrom ist die häufigste Kompressionsneuropathie peripherer Nerven. Obwohl die Anamnese mit dem nächtlichen Einschlafen der Hand (Brachialgia parästhetica nocturna) sehr typisch ist, ist eine klinisch-neurologische Untersuchung und Elektroneurografie in manchen Fällen auch eine Neurosonografie erforderlich. Im Anfangsstadium sind konservative Maßnahmen (Handgelenksschiene, Ergotherapie) empfehlenswert. Bei nicht Ansprechen der konservativen Therapie oder Auftreten von neurologischen Ausfällen ist eine Dekompression des N. medianus am Karpaltunnel indiziert.

Prof. Dr. med. Gregor Antoniadis
Berufsverband der Deutschen Chirurgie e.V.

S2e-Leitlinie „Distale Radiusfraktur“

CME: 2 Punkte

Dr. med. Benjamin Meyknecht, PD Dr. med. Oliver Pieske Das Webinar S2e-Leitlinie „Distale Radiusfraktur“ beschäftigt sich mit Fragen und Antworten zu Diagnostik und Klassifikation sowie Möglichkeiten des Ausschlusses von Zusatzverletzungen. Die Referenten erläutern, welche Frakturen konservativ behandelt werden können und wie. Das Webinar beantwortet die Frage nach aktuellen operativen Therapiekonzepten: Welcher Zugang, welches Osteosynthesematerial? Auf was muss bei der Nachbehandlung der distalen Radiusfraktur geachtet werden?

PD Dr. med. Oliver Pieske
Dr. med. Benjamin Meyknecht
Berufsverband der Deutschen Chirurgie e.V.

S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“

CME: 2 Punkte

Dr. med. Mihailo Andric
Inhalte des Webinars zur S1-Leitlinie „Empfehlungen zur Therapie der akuten Appendizitis bei Erwachsenen“ sind die Darstellung des Projektes und des Erstellungswegs zur S1-Leitlinie, die Erläuterung der klinischen Relevanz der Klassifikation EAES 2015, die wissenschaftliche Begründung der wichtigsten Empfehlungen und die Darstellung stadiengerechter Therapieoptionen.

Dr. med. Mihailo Andric
Berufsverband der Deutschen Chirurgie e.V.