机器人手术已成为治疗复杂肝脏恶性肿瘤的一种有前途的方法。本报告介绍了一名复发性肝细胞癌 (HCC) 和转移患者的单孔机器人肝切除病例，重点介绍了手术技术和结果。一名 18 岁女性，因纤维板层性 HCC 接受过左肝切除术使用达芬奇 SP 手术系统接受机器人肝脏切除术。该手术需要切除肝段 4 (Sg4) 中的 30 毫米肿瘤以及脾上极的腹膜转移瘤和心膈淋巴结转移瘤。手术方法包括粘连松解术、腹膜结节切除术、Sg4部分肝切除术、心膈淋巴结切除术。手术时间310分钟，失血37mL。患者术后过程顺利，8 天后出院回家。 Sg4 的部分肝切除术显示中度分化的 HCC，切除边缘呈阴性。此外，还切除了与转移一致的脾上极和心膈淋巴结的腹膜转移瘤。值得注意的是，达芬奇 SP 系统的重定位功能在本例中被证明是有用的，特别是对于患有多处远处转移的瘦削患者。此例强调了机器人手术中技术进步的重要性。达芬奇 SP 系统以其优越的特性，在充满挑战的临床场景中展现出前景。它能够促进患者受限腹腔内的精确导航和操作，从而实现了所观察到的成功结果。© 2024。外科肿瘤学会。

Robotic surgery has emerged as a promising approach for managing complex hepatic malignancies. This report presents a case of a single-port robotic liver resection for a patient with recurrent hepatocellular carcinoma (HCC) and metastases, focusing on the surgical technique and outcomes.An 18-year-old female with a history of left hepatectomy for fibrolamellar HCC underwent robotic liver resection using the Da Vinci SP Surgical System. The procedure entailed excising a 30 mm tumor in liver segment 4 (Sg4) along with peritoneal metastases in the superior pole of the spleen and cardiophrenic lymph node metastasis. Surgical techniques comprised adhesiolysis, resection of the peritoneal nodule, Sg4 partial liver resection, and excision of the cardiophrenic lymph node.The operative time was 310 min, with a blood loss of 37 mL. The patient experienced an uneventful postoperative course and was discharged home after 8 days. Partial liver resection of Sg4 revealed a moderately differentiated HCC with negative resection margins. Additionally, excision of peritoneal metastases in the superior pole of the spleen and cardiophrenic lymph nodes, consistent with metastasis, was performed. Notably, the Da Vinci SP system's relocation function proved useful in this case, particularly in slender patients with multiple distant metastases.This case underscores the importance of technological advancements in robotic surgery. The Da Vinci SP system, with its advantageous features, shows promise in challenging clinical scenarios. Its ability to facilitate precise navigation and manipulation within the patient's restricted abdominal cavity contributed to the observed successful outcome.© 2024. Society of Surgical Oncology.