Surgical Robot Can Help Safely Remove The Caudate Lobe

Resection of tumors successful nan caudate lobe (a deep, hard-to-reach portion of nan liver) is recognized arsenic 1 of nan astir technically challenging procedures successful hepatic room owed to its unsocial anatomical position and analyzable vascular relationships.

Researchers astatine Boston University Chobanian & Avedisian School of Medicine now show that it is imaginable to region nan caudate lobe safely utilizing a surgical robot, moreover successful an older patient, and still region nan crab completely. The objective lawsuit they picture successful nan diary Annals of Surgical Oncology, combines 2 "guidance" devices (1) a hanging/traction method utilizing nan Arantius ligament and (2) Indocyanine greenish (ICG) "negative staining" to intelligibly people nan caudate lobe boundaries and guideline a margin-focused crab cognition successful a very difficult area.

"The caudate lobe is 1 of nan astir technically demanding areas of nan liver-it's heavy and surrounded by captious vessels," said corresponding writer Eduardo Vega, MD, adjunct professor of surgery. "Robotic room tin thief america region prime tumors done smaller incisions, pinch little symptom and humor nonaccomplishment and quicker recovery, while still aiming for cure."

The researchers picture step-by-step a surgical method they utilized to dainty a 79-year-old diligent who had rectal crab and liver metastasis successful nan caudate region. They began by utilizing an intraoperative ultrasound to find nan tumor and representation adjacent important humor vessels. Using a surgical robot, they past utilized a hanging maneuver pinch nan Arantius ligament to unfastened a safe moving abstraction adjacent awesome vessels. Next, they temporarily blocked nan mini portal branch feeding nan caudate lobe and injected a mini dose of ICG dye (2.5 mg). Under nan near‑infrared camera, nan remainder of nan liver lit up while nan caudate lobe stayed dark, which allowed nan surgeons to spot nan borders intelligibly and protecting captious structures while removing nan caudate lobe.

After nan liver procedure, nan superior tumor (superior rectal cancer) was resected robotically. This enabled definitive crab resection wholly via a minimally invasive robotic approach, and nan diligent completed consequent curen without complications.

"Our extremity is to make analyzable liver tumor room safer and little invasive, truthful much patients tin retrieve faster and still person a curative operation. By combining robotic precision pinch ultrasound and fluorescence guidance, we dream to grow entree to high-quality crab surgery-even for tumors successful nan hardest-to-reach areas of nan liver," adds Vega, who besides is simply a hepato-bilio-pancreatic surgeon at Boston Medical Center.