Our initial experience with robotic hepato-biliary-pancreatic surgery

The authors performed Asia's first robotic surgery in March 2000 and a clinical trial was launched in the following year in order to obtain governmental approval for the da Vinci(A (R)) Surgical System. Fifty-two robotic surgeries were performed at Keio University Hospital, of which the authors performed 28 hepato-biliary-pancreatic surgeries. In robotic laparoscopic cholecystectomy, articulated monopolar electrocautery scalpels are flexible, enabling precise dissection around the gall bladder and clipless ligation of the cystic artery and cystic ducts. For laparoscopic hepatectomy, hepatic parenchyma was safely resected without hemorrhage by Glisson's pedicles ligation and bipolar hemostatic forceps. We review robotic laparoscopic cholecystectomy and hepatectomy and discuss the potential and future outlook for robotic hepato-biliary-pancreatic surgery.