Feasibility and perioperative safety of robotic liver resection using the da Vinci SP system: early single-center case series.

Authors

Takeshi Murakami, Masafumi Imamura, Koichi Okuya, Hideaki Kouda, Kohei Okamoto, Maho Toyota, Hiroki Fujino, Eiji Yoshida, Toru Kato, Kazuharu Kukita, Toru Mizuguchi, Takayuki Anazawa

Published in

Surgical endoscopy. Jul 01, 2026. Epub Jul 01, 2026.

Abstract

Clinical evidence for robotic liver resection (RLR) using the da Vinci SP™ system remains limited, particularly regarding perioperative outcomes during early implementation. We report an early single-center case series of RLR using the da Vinci SP system, primarily performed with a single-port (SP) -plus-one approach.
This retrospective study included consecutive patients who underwent RLR using the da Vinci SP system at a single institution. Prespecified safety endpoints were conversion, intraoperative transfusion, major complications (Clavien-Dindo grade ≥ IIIa), bile leakage, posthepatectomy liver failure (PHLF), posthepatectomy hemorrhage (PHH), readmission, and 30-day mortality. Bile leakage, PHLF, and PHH were defined according to International Study Group of Liver Surgery criteria. Operative metrics, postoperative stay, and margin status were also assessed.
Between October 2024 and December 2025, 20 patients underwent RLR using the da Vinci SP system. Median age was 74 years (range, 25-87), tumor size was 1.9 cm (range, 0.8-11.0), and Iwate difficulty score was 5 (range, 2-11). An SP-plus-one approach was used in 17 cases, whereas a true SP approach was used in 3. Anatomical resection was performed in eight patients, including four hemihepatectomies. No conversions or intraoperative transfusions were required. One patient experienced a major complication (duodenal ulcer bleeding requiring endoscopic hemostasis). No bile leakage, PHLF, PHH, readmissions, or 30-day mortality occurred. Median operative time was 283 min (range, 123-575), estimated blood loss was 33 mL (range, 5-200), and postoperative stay was 7.5 days (range, 4-11). R0 resection was achieved in all malignant cases.
In this early single-center case series, RLR using the da Vinci SP system was feasible in carefully selected patients, with no apparent increase in perioperative risk. These findings are descriptive and hypothesis-generating; larger multicenter prospective studies are warranted to define the clinical value and optimal role of the da Vinci SP in hepatobiliary surgery.

PMID:
42387007
Bibliographic data and abstract were imported from PubMed on 02 Jul 2026.

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