INTRAHEPATIC GLISSONIAN APPROACH FOR REPEAT ROBOTIC LEFT HEPATECTOMY
Marcel Autran Machado*, Fabio F. Makdissi, Marcel C C. Machado
Surgery, University of Sao Paulo, Sao Paulo, Sao Paulo, Brazil
A 59-year-old man with recurrent colorectal liver metastasis after two liver resections is referred. A new metastasis in S4 with involvement of the middle hepatic vein and the left glissonian pedicle is found. Multidisciplinary team decided for a left hepatectomy. Robotic repeat left hepatectomy using intrahepatic Glissonian approach was proposed. Total operative time was 294 minutes. The postoperative period was uneventful, and patient was discharged on the 4th postoperative day. Robotic intrahepatic Glissonian approach is feasible and is a useful technique for rapid and safe control of the left liver pedicle, facilitating robotic left hemihepatectomy, even after previous hepatectomies.
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