To explore the safety and application value of da Vinci robot-assisted hepatectomy in clinical practice.

Clinical data of 71 patients undergoing da Vinci robot-assisted hepatectomy in the First Affiliated Hospital of Sun Yat-sen University from April 2015 to December 2018 were retrospectively analyzed. The informed consents of all patients were obtained and the local ethical committee approval was received. Among them, 48 patients were male and 23 female, aged 18-76 years with a median age of 56 years. 54 cases were diagnosed with malignant liver tumors, 4 cases of benign liver tumors, 1 case of hilar cholangiocarcinoma, 1 case of liver cyst, 10 cases of hepatolithiasis and 1 case of type Ⅴ congenital choledochal cyst. The clinical outcomes of patients were analyzed.

Robot-assisted hepatectomy was successfully performed in 90% (64/71) of the patients. The conversion rate to open surgery was 10% (7/71). Among them, 15 cases underwent left hemihepatectomy, 2 cases of left hemihepatectomy combined with caudate lobectomy, 7 cases of right hemihepatectomy, 1 case of mesohepatectomy. 28 cases received resection of 2 or more segments. 18 cases received local resection of tumor or resection of 1 segment. The median time of robot-assisted surgery was 285(196, 374) min, and the intraoperative blood loss was 100(50, 300) ml. Postoperative pathological examination revealed that the R0 resection rate was 100%. The incidence of postoperative complications was 11%(8/71), including 4 cases of abdominal infection, 1 case of urinary infection, 1 case of deep venous thrombosis, 1 case of hepatic insufficiency and 1 case of cerebral infarction. All of them were cured after conservative treatments. No perioperative death occurred. The length of postoperative hospital stay was 8(7-11) d.

Compared with the traditional surgery, robot-assisted hepatectomy has the advantages of more accurate anatomical dissection and more flexible operations, which is a safe and feasible minimally invasive surgery.