Multivisceral Resection in Robotic Liver Surgery

Minimally invasive surgery techniques are expanding in utilization in liver resections and now include robotic approaches. Robotic liver resection has been demonstrated to have several benefits, including surgeon ergonomics, wrist articulation, and 3D visualization. Similarly, for multivisceral liver resections, the use of minimally invasive techniques has evolved and expanded from laparoscopy to robotics. The aim of this article is to review the literature and describe multivisceral resections, including hepatectomy, using a robotic technique. We describe over 50 published cases of simultaneous robotic liver resection with colon or rectal resection. In addition, we describe several pancreatectomies performed with liver resection and one extra-abdominal pulmonary resection with liver resection. In total, these select reported cases at experienced centers demonstrate the safety of robotic multivisceral resection in liver surgery with acceptable morbidity and rare conversion to open surgery. As robotic technology advances and experience with robotic techniques grows, robotic multivisceral resection in liver surgery should continue to be investigated in future studies.

Augmented Reality and Image-Guided Robotic Liver Surgery

Artificial intelligence makes surgical resection easier and safer, and, at the same time, can improve oncological results. The robotic system fits perfectly with these more or less diffused technologies, and it seems that this benefit is mutual. In liver surgery, robotic systems help surgeons to localize tumors and improve surgical results with well-defined preoperative planning or increased intraoperative detection. Furthermore, they can balance the absence of tactile feedback and help recognize intrahepatic biliary or vascular structures during parenchymal transection. Some of these systems are well known and are already widely diffused in open and laparoscopic hepatectomies, such as indocyanine green fluorescence or ultrasound-guided resections, whereas other tools, such as Augmented Reality, are far from being standardized because of the high complexity and elevated costs. In this paper, we review all the experiences in the literature on the use of artificial intelligence systems in robotic liver resections, describing all their practical applications and their weaknesses.

Deteksi Endoparasit Cacing pada Hepar Tikus Laboratorium (Rattus norvegicus) dari Sentra Peternak di Kabupaten Banyumas dan Kabupaten Purbalingga

The presence of laboratory rats that are maintained and bred for laboratory purposes or laboratory observations is very necessary. The presence of endoparasite in laboratory rats will have an impact on the result of the research or laboratory observations. This study aims to detect helminth endoparasites in the liver of laboratory rats (Rattus norvegicus) from animal breeders in Banyumas and Purbalingga Districts. This research was an observational study with a cross-sectional design. A total of 52 laboratory rats were used in the study. Rats are killed with chloroform, liver surgery then identify the presence of worm larvae. Out of the 52 rats obtained, 7 (29.17%) from 24 laboratory rats in Banyumas District and 5 (17.86%) from 28 laboratory rats in Purbalingga District were infected with Taenia taeniaeformis. It is necessary to control helminth infections in laboratory rats, such as laboratory animal quarantine, health monitoring, and antihelmintic treatment. It is important to handle carefully during travel to assure the results of research or laboratory observations using the animals.