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- W2895020246 abstract "Introduction: Although laparoscopy is the gold standard to cholecystectomy, its use to approach incidental gallbladder cancer (IGBC) is uncommon. The laparoscopic bisegmentectomy IVb/V (either anatomical or not) plus hilar lymphadenectomy represents a challenging procedure. We report our initial experience with robotic approach to IGBC as an option to improve feasibility of this procedure. Methods: Three consecutive patients undergone robotic reoperation by daVinci® SI, and by the same team were reported. Patients were positioned in reverse Trendelenburg. For all patients, five trocars were used (3 of 8 mm and 2 of 12 mm), and surgical specimens were removed through Pfannestiel incisions. Results: From November 2016 to December 2017, three cases of IGBC were performed. Clinicopathological, operative and postoperative data are summarized in the table. Briefly, all patients underwent bisegmentectomy IVb/V (1 anatomical and 2 non-anatomical) plus hilar lymphadenectomy; they were pT1b, and neither presented residual liver disease nor positive node at final pathology. Neither Pringle maneuver nor blood transfusions were necessary. All discharges from ICU and hospital were on second and third postoperative days, respectively. No complications at 30-days were recorded. Conclusion: Our initial experience suggests that robotic reoperation seems to be safe, and simplifies both hilar lymphadenectomy as well as intrahepatic control of pedicles allowing anatomic resections. The putative benefits of its approach are the articulate arms facilitating traction and dissection of hilar structures with precise movements and tridimensional view. Both articulate mono and bipolar scalpels helped to work bi-axially on the liver wedge necessary to remove segments IVb/V with their pedicles.Tabled 1Clinic, operative and postoperative dataCharacteristicOverall1st case2nd case3rd caseAge45 ± 11533349Gender (Female)2 (66.7%)FemMaleFemBody mass index30.9 ± 129.931.830.9ASA scoreII (66.7%)IIIIIIwate criteria (difficult score)4 (4–7)447Anatomical resection1 (33.3%)NoNoYesNode Harvesting (range)4 (3–6)634Operative time (min)392 ± 16380410385Estimated Blood Loss (ml)186 ± 12650200300 Open table in a new tab" @default.
- W2895020246 created "2018-10-12" @default.
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- W2895020246 date "2018-09-01" @default.
- W2895020246 modified "2023-09-26" @default.
- W2895020246 title "Robotic approach simplifies the reoperation of incidental gallbladder cancer" @default.
- W2895020246 doi "https://doi.org/10.1016/j.hpb.2018.06.1532" @default.
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