Application Of Da Vinci Surgical System In Hepatopancreatobiliary Surgery

Da Vinci Surgical System (DVSS) is a novel minimally invasive surgery technique which rose in recent years. It depends on the unprecedented technical superiority to other methods, and upgrades the accuracy and feasibility of surgery to a totally new level. Since the approval for clinical application by Food and Drug Administration (FDA), it has been gradually carried out in the operations of urology, cardiothoracic surgery, gynecological and abdominal surgery, mostly involves all the surgical procedures of the above-mentioned fields. However, for hepatopancreatobiliary surgery, because of the complex and changeable anatomical structure of the liver, biliary tract and pancreas, it has the "bottleneck"in the future development of traditional laparoscopic surgery. The emergence of DVSS provides great technical conditions for the development of minimally invasive surgical in hepatopancreatobiliary surgery. Objective:To investigate the safety, feasibility and advantages of DVSS used for hepatopancreatobiliary surgery.Methods:Report the preliminary application and clinical experience of DVSS assisted hepatopancreatobiliary surgery carried out in our institute. Which includes one case of DVSS assisted hepatectomy for giant hemangioma, one case of DVSS treatment cholelithiasis combined with cholecystoduodenal fistula, and one case of DVSS assisted distal pancreatectomy with preservation of the spleen. The surgical procedure and postoperative recovery of patients were analysed.Results:All of the three patients had successfully undergone robotic surgery. Case l:The operative time was236minutes, and the estimated intraoperative blood loss was120ml. The patient could mobilize and had liquid diet on the1st day after operation. The index of post-operative bowel venting was2days, and then he had semi-liquid diet. He discharged from our hospital on the3rd day. Case2:The operative time was216minutes, and the estimated intraoperative blood loss was80ml. The index of post-operative bowel venting was2days, and the patient discharged from our hospital at the7th day postoperative after taking out the suture. Case3:The operative time was200minutes, and the estimated intraoperative blood loss was100ml. The patient could mobilize on the1st day after operation. The index of post-operative bowel venting was2 days, and then he had semi-liquid diet. He discharged from our hospital on the6day. All three patients were follow-up visited after three months of the operations, there was no complication occurred.Conclusions:DVSS assisted hepatopancreatobiliary surgery is security and feasible. It has advantages including shorter incision, less trauma, more clear and intuitive vision, and has efficacious clinical effects. It broadens the applications of minimally invasive surgery for hepatopancreatobiliary surgery.