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Medanta Institute of Liver Transplantation and Regenerative Medicine, India
Title: Robotic liver resections –My experience

After completing general surgical residency, got further training in surgical gastroenterology, HPB and Liver transplantation for three years followed by clinical fellowship in Liver transplantation. Have been working as senior consultant HPB and liver transplant surgeon with experience of nearly 2000 liver transplants, including both deceased and live donor. Have done more than thousand live donor hepatectomies and many complex liver resections involving vascular reconstructions. Also leading minimal access HPB surgery in the unit presently working. Did first Robotic hepatectomy in India. Published first case report and first series of robotic liver surgery from India. Am European Board certified(UEMS) in liver transplantation. Have authored (first or co author) many publications. My recent publication being Right Lobe Donor Hepatectomy, Is it safe? In Transplant International Journal. My areas of interest are safety of living donor hepatectomy, machine organ perfusion, Robotic liver surgery and complex liver resections.


Background: The authors present their experience of robotic liver resections in comparison with open surgery.
Methods: Retrospective review of liver resections done robotically from February 2015 to Octuber 2017 compared to cohort of open cases from January 2012 to December 2016.
Results: Nineteen patients in the study group were compared with matched control of 38 open cases. Mean operative duration was 442 ± 135 minutes in the robotic compared to 357 ± 127 minutes in control group (p = 0.03). Mean blood loss was 270 ± 311 ml in the robotic compared to 451 ± 330 ml in control group (p = 0.06). Minor complications developed in 17% of robotic cases compared to 41% in open surgery (p = 0.5), while major complications occurred in 5.8% of robotic cases compared to 8.8% of open (p = 0.3). Mean hospital stay was 5.35 ± 0.8 days for the robotic group and 7.7 ± 4.2 days for open group (p = 0.02).
Conclusion: This study highlights the utility of robotics for liver resections with better outcomes and decreased length of stay compared to open surgery albeit at a higher cost at present.

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