Robotic Partial Central Hepatectomy for Juxtahilar Tumor: Technique of Middle Hepatic Vein Tangential Reconstruction

作者：Touadi M, Ross S, Sucandy I · 发表于：Annals of surgical oncology · 年份：2026 · DOI：10.1245/s10434-025-18706-7 · 研究领域：Hepatectomy、Robotic Surgical Procedures、Hepatic Veins、Liver Neoplasms、Plastic Surgery Procedures、Breast Neoplasms、Adenocarcinoma、Humans、Female、Middle Aged、Prognosis

BACKGROUND: Minimally invasive techniques for resection of centrally located tumors near the region of hepatic duct bifurcation poses technical concerns to many hepatobiliary surgeons. Excessive bleeding, inadvertent injury to the hilar plate with subsequent bile leak and abdominal sepsis, and involvement of the middle hepatic vein (MHV) often deter surgeons from using a minimally invasive technique in this circumstance. An emerging robotic method with advantages over conventional laparoscopy offers greater technical feasibility for peri-/juxtahilar dissections and MHV ligation/reconstruction. Although robotic portal vein resection and reconstruction has been established and widely reported in the literature, especially in pancreaticoduodenectomy or Klatskin tumor resection,1-5 technical descriptions of hepatic vein reconstruction remain limited. Herein, we describe our technique for robotic partial central hepatectomy for juxtahilar tumor, highlighting steps of MHV tangential reconstruction to avoid congestion of the associated hepatic parenchyma drained by the MHV trunk. METHODS: A 57-year-old woman presented with a single 5 cm segment V hypermetabolic mass, concerning for metastatic breast cancer without evidence of extrahepatic disease. She had a multifocal invasive adenocarcinoma requiring partial mastectomy and antiestrogen treatment 11 years before her current presentation. Magnetic resonance imaging showed a 5 cm liver mass almost in contact with the hepatic duct bif...