Segment 7: Robot-Assisted Approach

Abstract

Laparoscopic liver resection (LLR) was initially indicated for benign and peripherally located lesions, suggesting concern about the oncologic effectiveness of these procedures and a fear of massive bleeding when approaching posterior and superior liver segments [1]. A right hepatectomy remains the preferred choice for deeply located lesions in segments 7 (S7) and 8 by most laparoscopic liver surgeons to avoid curved and angulated transection lines close to the right hepatic vein (RHV) and the inferior vena cava (IVC) [2]. However, in the last few years, the number of minimally invasive complex liver resections has increased, and even segmentectomies of the posterosuperior (PS) segments have been successfully performed [2–4]. Thus, laparoscopic segmental and subsegmental resection of S7 are an important step toward the fulfillment, even in minimally invasive surgery, of the principles of parenchyma preservation that represent the actual trend in the treatment of both colorectal liver metastases and hepatocellular carcinoma [5].