Radical Robot-Assisted Liver Resection for Alveolar Echinococcosis
Mikhail Efanov, MD, PhD, Ruslanh Alikhanov, MD, PhD, Victor Cvirkun, MD, PhD, Ivan Kazakov, MD, PhD, Olga Melekhina, MD, PhD, Pavel Kim, MD, Andrey Vankovich, MD, Igor Khatkov, MD, PhD
Department of Hepato-pancreato-biliary Surgery, Moscow Clinical Scientific Center, Moscow, Russia (Drs. Efanov, Alikhanov, Kazakov, Melekhina, Kim, and Vankovich and Prof. Cvirkun). Moscow Clinical Scientific Center, Moscow, Russia (Prof. Khatkov).
Introduction: Radical surgery is the only curative method for liver alveolar echinococcosis (AE). To date, there is no information about the efficacy of laparoscopy including robot-assisted liver resection in radical treatment of AE. This is a case report of a robot-assisted radical liver resection for AE.
Case Description: A 51-year-old man was admitted to the clinic with complaints of weakness and pain in the right abdomen. Computed tomography (CT) revealed a lesion measuring 46 52 86 mm, located in liver segments VI and VII, and robot-assisted resection of those segments was performed. The surgery lasted for 485 minutes, and intraoperative blood loss was 1000 mL. The position of the patient, sites of trocars placement, and details of the surgery are described. The patient had an uneventful postoperative course and was discharged on day 10. Albendazole, was administered for 2 years as antiparasitic chemotherapy. Dynamic monitoring for more than 13 months showed no recurrence of the disease.
Discussion: Publications on the use of laparoscopic and robotic resection of posterior liver segments are scarce, but experience has shown that the learning curve for the use of the robotic system is shortened in comparison with that for other approaches. After the case reported herein, we have performed similar procedures and have seen a marked decrease in blood loss and operative time. This case and our growing experience in performing radical robot-assisted liver resections demonstrate the feasibility of using robotic laparoscopic approaches for radical treatment of early diagnosed liver AE, particularly when the affected liver segment is difficult to reach.
Key Words: Alveolar echinococcosis, Hepatectomy, Liver resection, Radical treatment, Robotic surgical procedures