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<p>The caudate lobe of the liver, owing to its deep anatomical location, represents one of the most formidable challenges in hepatic surgery. Resection of caudate lobe tumors using conventional approaches is often hampered by difficult exposure, limited operating space, and the proximity to major vessels, leading to a considerable risk of uncontrollable hemorrhage. We describe a novel robotic-assisted technique utilizing the anterior to inferior vena cava space (AIVCS) as a key anatomical plane. This dorsal-first approach was successfully applied in three consecutive patients with caudate lobe tumors. The procedure provided excellent exposure and precise visualization of critical structures, which facilitated a clear and controlled dissection. Consequently, all resections were completed successfully with minimal intraoperative blood loss. The robotic dorsal first approach via the AIVCS is a safe and feasible technique for caudate lobectomy. It offers superior visualization and enhances surgical control, potentially mitigating the traditional risks associated with tumors in this location. Herein, we report our initial experience and technical details.</p>

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A Novel Technique: Robotic Caudate Lobectomy Using a Dorsal First Approach Through the Anterior to Inferior Vena Cava Space

  • 期刊论文

  • 发表日期：

    2026年3月16日

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  • Mingyang Li,
  • Jiafeng Zhang,
  • Bo Zhang,
  • Pengpeng Liu,
  • Binjie Li,
  • Zhuo Meng,
  • Quanyan Liu

摘要

The caudate lobe of the liver, owing to its deep anatomical location, represents one of the most formidable challenges in hepatic surgery. Resection of caudate lobe tumors using conventional approaches is often hampered by difficult exposure, limited operating space, and the proximity to major vessels, leading to a considerable risk of uncontrollable hemorrhage. We describe a novel robotic-assisted technique utilizing the anterior to inferior vena cava space (AIVCS) as a key anatomical plane. This dorsal-first approach was successfully applied in three consecutive patients with caudate lobe tumors. The procedure provided excellent exposure and precise visualization of critical structures, which facilitated a clear and controlled dissection. Consequently, all resections were completed successfully with minimal intraoperative blood loss. The robotic dorsal first approach via the AIVCS is a safe and feasible technique for caudate lobectomy. It offers superior visualization and enhances surgical control, potentially mitigating the traditional risks associated with tumors in this location. Herein, we report our initial experience and technical details.