PMC9237532_01
(A) Preoperative MRI of the patient with enhanced arterial phase. (B) Preoperative MRI of the patient with enhanced venous phase. (C) Delayed phase of preoperative MRI enhancement in the patient. (D) Main hepatic vein (MHV) trunk and V5 and V8 branches were labeled in accordance with the three-dimensional stereo images of hepatic vessels reconstructed by imaging. (E) S4, S5, and S8 reconstruction images of liver segments.
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F1
Liver MRI plain scan and enhanced examination were further refined, which suggested a lesion in S8 (Figures 1A-C). As shown in Figures 1D, E, the tumor was located in S8, near S4 and adjacent to the main trunk of MHV.
(A) Human distribution position of Xi trocar. (B) S4 and S5 segments were isolated, revealing the V5 branch of the MHV. (C) Trunk of the MHV was cut. (D) Intraoperative fluorescence imaging of the tumor was performed to facilitate complete resection of the tumor. (E) Isolation and resection of tumors. (F) MHV reconstruction using artificial blood vessels of expanded polytetrafluoroethylene material. (G) Schematic of the completion of MHV reconstitution.
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F2
The first, second, third, and fourth robotic arms were docked on the right hypochondrium, on the camera, 2 cm below the xiphoid process, and on the left hypochondrium ports, respectively (Figure 2A).
(A) Artificial vessels, which were visualized by ultrasound one week after operation, were approximately 42.7 mm in length. (B) Blood flow of artificial blood vessels displayed by ultrasound one week after operation (blue). (C) Ultrasound blood flow spectrogram of artificial vessels one week after operation, showing blood flow patency.
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F3
The patient received rivaroxaban for 3 months after the procedure, and her coagulation profile was checked regularly (Figure 3).