Contents lists available at ScienceDirect Surgical Oncology journal homepage: www.elsevier.com/locate/suronc Robotic right hepatectomy for a central liver tumor- A video of the surgical technique - Carolijn L.M.A. Nota, I. Quintus Molenaar, Inne H.M. Borel Rinkes, Jeroen Hagendoorn ∗ Dept. of Surgery, G.04.2.28., UMC Utrecht Cancer Center, Utrecht, the Netherlands ARTICLE INFO Keywords: Robotic liver surgery Minimally invasive surgery Liver resection ABSTRACT Background: Robotic surgery is gaining momentum in liver resection. Instrumentation of the surgical robot is articulated, movements are scaled and the view of the operative field is 3-dimensional and magnified[1, 2]. Thus, these technical enhancements allow for a more precise dissection and curved work axes, as needed in liver resection. Aim of this video was to demonstrate the feasibility of fully robotic right hepatectomy with dissection of the variant right hepatic pedicles for a centrally located liver tumor. Methods: This video illustrates robotic right hepatectomy in a 77-year-old male. A liver tumor in segment 5/8 with concurrent biliary dilation was detected on a CT-scan made in the course of his cardiac history. An addi- tional MRI scan suggested the diagnosis of hepatocellular carcinoma or intrahepatic cholangiocarcinoma for which a right hepatectomy was indicated. Results: After anesthesia, the patient was placed supine on a split-leg table in anti-Trendelenburg and left lateral tilt position. Four robotic trocars were placed and the da Vinci Xi robotic system was docked. Two laparoscopic ports were placed for tableside assistance. Right hepatectomy was performed including separate dissection of the posterior and anterior pedicles. The robotic Vessel Sealer was employed as main parenchymal transection device. Postoperative hospital stay was unremarkable. The patient was discharged on postoperative day 6. Conclusion: This video illustrates the feasibility of a robotic approach to right hepatectomy. The increased surgical dexterity, as provided by the articulating robotic instrumentation, allows for precise dissection of the liver hilum, as needed in resection of centrally located tumors. Disclosures Declarations of interest: Dr. I.Q. Molenaar and Dr. J. Hagendoorn are proctor for Intuitive Surgical (Intuitive Surgical Inc., Sunnyvale, CA, USA). The content of this study is solely the responsibility of the authors and does not necessarily represent the official views of Intuitive Surgical. Dr. Nota and prof. Borel Rinkes have declared no conflict of interest. Authorship statement All authors have made substantial contributions to all of the fol- lowing: (1) the conception and design of the study, or acquisition of data, or analysis and interpretation of data, (2) drafting the article or revising it critically for important intellectual content, (3) final ap- proval of the version to be submitted. Funding sources This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors. Appendix A. Supplementary data Supplementary data to this article can be found online at https:// doi.org/10.1016/j.suronc.2019.06.009. References [1] U. Leung, Y. Fong, Robotic liver surgery, Hepatobiliary Surg. Nutr. 3 (2014) 288–294. [2] C. Nota, I.H. Borel Rinkes, J. Hagendoorn, Setting up a robotic hepatectomy pro- gram: a Western-European experience and perspective, Hepatobiliary Surg. Nutr. 6 (2017) 239–245. https://doi.org/10.1016/j.suronc.2019.06.009 Received 28 May 2019; Accepted 27 June 2019 ∗ Corresponding author. Dept. of Surgery, UMC Utrecht Cancer Center, G04.2.28, Heidelberglaan 100, 3583 CX, Utrecht, the Netherlands. E-mail address: j.hagendoorn-3@umcutrecht.nl (J. Hagendoorn). Surgical Oncology 30 (2019) 108 0960-7404 T