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ISMETT Performs World’s First Fully Robotic Right Hepatectomy for Adult-to-Adult Living-Donor Liver Transplant

PALERMO, Italy June 28, 2012 – Physicians at the Istituto Mediterraneo per i Trapianti e Terapie ad Alta Specializzazione (ISMETT) have performed the world’s first minimally invasive right liver lobe resection and procurement for an adult-to-adult living-donor liver transplant.
The procedure was performed using the da Vinci® robotic surgical system. This is the first case in the world performed entirely with the robotic technique. In the past, some living-donor liver transplants had been performed in the U.S. using the robot, but aided by the surgeon who inserted his hand through an abdominal incision to perform the surgery with the robot. The case carried out at ISMETT was exceptional because it was entirely performed with the robotic minimally invasive technique; only the robot’s arms operated inside the donor’s abdomen.
During this surgery, five small incisions and a 9-centimeter incision were needed to remove the right liver lobe from a 46-year-old man. The lobe was then transplanted to his 44-year-old brother, who suffered from liver cirrhosis. The surgery, which took place in March, lasted about 10 hours. Both brothers are now home and have experienced no complications.
A surgical team of a dozen doctors and nurses was involved in the operating room. The team was led by Bruno Gridelli, M.D., ISMETT’s director, and Marco Spada, M.D., chief of ISMETT’s Abdominal and Transplantation Surgery Unit.  The procedure was performed in collaboration with a team from Cisanello University Hospital of Pisa led by Ugo Boggi, M.D., chief of the Division of General and Transplant Surgery in Uremic Patients.
“This breakthrough event at ISMETT is a perfect example of a successful collaboration between transplant centers from different Italian regions, and of how such collaborations can encourage progress in the field of transplant surgery,” Dr. Gridelli said.
ISMETT and its partner UPMC are known internationally as pioneering transplant programs that have led the way in transplant innovations. Together, the  programs have performed more than 19,000 procedures in over 30 years.
The da Vinci® robotic system consists of a patient-side cart with four interactive robotic arms that position and maneuver miniaturized instruments introduced in the donor’s abdominal cavity through small incisions. A console allows the surgeon to have an enlarged 3D high-definition view of the abdominal cavity while the technology translates the movements of the surgeon's hands and fingers into precise movements of the surgical instruments inside the patient.

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