December 2, 2023

The first robotically performed liver transplant has been successfully performed in the United States, an exciting step in surgical advancement and clinics plan to make the innovative procedure more widely available.

The man in his 60s, who needed a critical transplant due to liver cancer and cirrhosis caused by hepatitis C, was operated on by the advanced machinery while the surgeon controlled the robot’s movements from a nearby console.

Dr. Adeel Khan, a transplant surgeon on the Washington University School of Medicine surgeon team, said: “The transplant was very successful: the operation went well, the new liver started working immediately, and the patient recovered without any surgical complications. .” Barnes Jewish Hospital of St. Louis.

One month after surgery, the recipient is walking comfortably and hopes to return to golf and swimming. Traditionally, it takes patients about six weeks to be able to move without discomfort.

The hospital has been working to develop this cutting-edge technology to minimize the invasiveness of the procedure, thereby providing patients with better recovery times and outcomes. Surgeons have performed more than 30 kidney transplants and other operations involving the bile duct, pancreas and stomach using the robotic system, but this is theirs, and the nation’s first liver transplant.

“Liver transplantation is one of the most complex abdominal procedures and relies heavily on a professional team to achieve a good outcome,” said Dr. Khan.

Traditionally, the surgeon makes a 3 to 4 inch (7.6 to 10 cm) vertical incision and a 12 to 16 inch (30 to 41 cm) horizontal incision below the ribcage to remove diseased tissue. liver and replace it with a healthy donor organ. Due to the nature of the procedure, which can involve heavy bleeding and requires delicate suturing of small blood vessels, it was considered too difficult to perform the procedure in a less invasive manner.

Robotic surgery is changing all that. During this successful transplant, several half-inch (1.3 centimeter) keyhole incisions and a six-inch (15 centimeter) vertical incision were made between the abdominal muscles, allowing the liver to be removed. The surgeon sits in front of a nearby screen and manipulates the robot’s tools via a joystick-like controller. The screen displays the surgical site in high-resolution 3D, enabling more precise and complex surgeries than conventional methods.

The transplant took just over eight hours, but surgeons are confident that time will shorten as the procedure becomes more common in the operating room.

“Given the difficulty of removing a failing liver and successfully implanting a new organ, liver transplantation is the most difficult abdominal organ to consider in a minimally invasive approach,” said Dr. William Chapman, chief of general surgery at Washington University. “Further utilization of this technology is needed.” to determine the extent of benefit of liver transplantation as a minimally invasive procedure.”

The da Vinci Surgical System has changed the way medical personnel operate. More patients are expected to be operated on by robotic surgeons soon, as training and the technology rolls out across the country.

“We have five Transplant Services surgeons performing robotic surgery, and that number will grow to seven by the end of the summer,” Khan said. “Since the inception of our program, we have directed over 30 transplant centers across the country to establish their own successful robotics programs. Transplant teams from other centers come to observe our process, and we also visit their sites and mentor them in developing their skills. “

Not surprisingly, the potential artificial intelligence How to operate the machines is being explored, which could be the next frontier of advances in robotic surgery.

source: Washington University School of Medicine in St. Louis