Breakthrough Surgery: Robotic Hepatectomy for Large Liver Tumour

The surgery lasted nine hours and was well endured by Mr. Yadav. The post-surgical tissue-test results confirmed clear margins confirming complete removal of the cancerous tumour.

Occasional episodes of abdominal pain and discomfort may not raise immediate alarms as major health concerns. But when they become frequent, severe, or persistent, or when concerning symptoms like unintentional weight loss are added, it is a strong indication that something requires serious medical attention. 

That was exactly the situation faced by 33-year-old Mr Shekar Yadav (Name Changed). Worried about his worsening health, he consulted Dr Lohith P, Associate Consultant – Robotic Surgical Gastroenterology and GI Onco-Surgery at Manipal Hospital Yeshwanthpur.

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A detailed assessment, including imaging and other diagnostic tests, revealed a large tumour, measuring nearly 15 cm, occupying the right side of his liver. Advanced diagnostic workup with tissue microscopy studies confirmed intrahepatic cholangiocarcinoma. a rare and aggressive cancer arising from the bile ducts within the liver. “This is an uncommon liver cancer that arises from the bile ducts within the liver. It is a very aggressive cancer. But, when detected before it spreads, surgery offers the best chance of cure. When we performed a PET CT scan for Mr. Yadav, the cancer was found to be confined to the liver. This made him eligible for curative surgery, but the key here was precise planning and complete removal of the tumour,” explains Dr. Lohith P.

A carefully planned, robot-assisted right hepatectomy was chosen for tumour removal. The benefits such as magnified 3D vision and enhanced precision that the advanced robotic system offered, were critical in this surgery as the tumour was located in an anatomically high-risk region. “The tumour was pressing against Inferior Vena Cava and the Right Hepatic Vein, two of the body’s most vital blood vessels. Operating in this region leaves no room for error. Robotic systems give us excellent control. During the most critical phase near major blood vessels, we shifted to safest open cusa technique to have complete vascular control and achieve good oncologic margin. Every decision was guided by one priority, patient safety with total tumour removal,” adds Dr. Lohith P.

The surgery lasted nine hours and was well endured by Mr. Yadav. The post-surgical tissue-test results confirmed clear margins confirming complete removal of the cancerous tumour. Mr. Yadav showed remarkable recovery in the days following the surgery. He was discharged 5 days after surgery with homecare and follow up instructions.

This case reminds us, cancers such as intrahepatic cholangiocarcinoma often go unnoticed until symptoms become serious and disease more advanced. Hence, paying attention to even subtle symptoms becomes important, particularly in younger individuals.

The case also underscores the strength of Manipal Hospital Yeshwanthpur’s integrated approach combining experience, teamwork, and the wisdom to balance innovation through robotic infrastructure with safety to deliver the best patient outcomes.