First Robotic Complex Liver Surgery

Main Category: Liver Disease / Hepatitis
Article Date: 09 Apr 2005 - 23:00 PDT

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Surgeons at the University of Illinois Medical Center at Chicago have successfully performed the first robotic complex liver surgery in the United States.

"The robot is superior to traditional laparoscopic surgery because it provides a 360-degree range of motion not possible with traditional laparoscopic instruments," said Dr. Giuliano Testa, associate professor of surgery at UIC. "The robot provides access to all the fine structures of the liver and allows us to see the delicate blood vessels. In the very near future, it will be difficult to justify open abdominal surgery for the vast majority of patients."

Laparoscopic, or minimally invasive surgery, is performed through tiny port openings rather than a large incision. Robotic surgery vastly expands laparoscopic capabilities by allowing surgeons to view the operating field in 3-D using a tiny camera to manipulate instruments more precisely. The robotic system provides a full range of motion using an instrument modeled after the human wrist.

"I feel like I did too many sit ups," said Linda Kahan, a 55-year-old Evanston woman as she prepared to leave the hospital just 48 hours after the procedure.

Kahan suffered from abdominal pain due to a large benign tumor about five inches in diameter. Surgeons performed a laparoscopic right hepatectomy, removing approximately 60 percent of her liver, and the tumor using the da Vinci® Surgical System.

Surgeons made five one-centimeter incisions in Kahan's abdomen. Using the da Vinci System, they then inserted the laparoscope and robotic arms through the incisions to precisely control the real-time movements of the surgical instruments inside the patient.

"I thought it was really amazing that my surgery was performed using the robot," Kahan said. "I knew there was a possibility that my surgery would be done laparoscopically, but I was concerned that I might need open surgery because of the size of the tumor."

Kahan's liver will regenerate within four to six weeks. The procedure spared her from open abdominal surgery, an eight-inch scar and a prolonged recovery.

Benefits of robotic surgery are consistent with laparoscopic surgery and include less blood loss, faster recovery, less scarring and reduced post-operative pain. In addition, the robotic technology extends the surgeon's capabilities and makes complex minimally invasive surgical procedures "feel" more like open surgery than does laparoscopic surgery.

Surgeons at UIC performed the first robotic surgery in Illinois in 2000. Since then, they have performed more the 500 robotic surgeries for a variety of procedures including gall bladder removal, gastric bypass and Lap-Band for treatment of obesity, esophageal repair and kidney donation.

While robotic surgery has been widely adopted for certain minimally invasive surgical procedures, it has not yet been widely used for complex procedures such as liver resection.

UIC was the first of three sites in the United States to provide federally mandated clinical training for surgeons using the robotic system.

"UIC has been involved in robotic surgery since the beginning, and our patients appreciate that we can offer them the latest in minimally invasive surgical care," said Dr. Santiago Horgan, director of minimally invasive surgery at UIC.

The da Vinci Surgical System is the first surgical robotic system cleared by the U.S. Food and Drug Administration for a variety of procedures to treat the heart, lungs, kidneys, gastrointestinal tract and prostate.

UIC ranks among the nation's top 50 universities in federal research funding and is Chicago's largest university with 25,000 students, 12,000 faculty and staff, 15 colleges and the state's major public medical center. A hallmark of the campus is the Great Cities Commitment, through which UIC faculty, students and staff engage with community, corporate, foundation and government partners in hundreds of programs to improve the quality of life in metropolitan areas around the world.

For more information about UIC, visit http://www.uic.edu