“The caudate lobe is one of the most technically demanding areas of the liver—it’s deep and surrounded by critical vessels,” said corresponding author Eduardo Vega, MD, assistant professor of surgery. “Robotic surgery can help us remove select tumors through smaller incisions, with less pain and blood loss and quicker recovery, while still aiming for cure.”

The researchers describe step-by-step a surgical technique they used to treat a 79-year-old patient who had rectal cancer and liver metastasis in the caudate region. They began by using an intraoperative ultrasound to find the tumor and map nearby important blood vessels. Using a surgical robot, they then used a hanging maneuver with the Arantius ligament to open a safe working space near major vessels.