Early experiences in robotic single-site plus one port platform for complex hepatobiliary and pancreatic surgery

BackgroundMinimal invasive surgery in hepatobiliary and pancreatic (HBP) surgery has been accepted worldwide in recent years. However, applications of single-site laparoscopic surgery in complex HBP surgery have been limited due to difficulty in manoeuvring instruments and the limited range of motion resulting from clashing instruments.MethodsTo overcome the limitations, we have used the Da Vinci single-site surgical platform with one additional port in a Da Vinci Xi system to perform donor right hepatectomy, pancreaticoduodenectomy, and combined resection of the common bile duct and spleen vessels preserving distal pancreatectomy.ResultsIn selected patients, using a robotic single-site plus one port system allowed the successful completion of complex HBP surgery.DiscussionComplex HBP surgery can be performed safely in a stable environment using the robotic single-site plus one port system. Further exploration of a robotic single-site plus one port in complex HBP surgery is necessary.