开放根治性胆囊切除术是目前胆囊癌治疗的“金标准”。对于精心挑选的患者，机器人根治性胆囊切除术 (RRC) 可能是一种合适的替代方案，可提供术后立竿见影的益处，例如更少的失血、更短的住院时间和更少的并发症，同时在肿瘤学上具有等效性。然而，它需要更长的学习曲线。1 方法：该视频演示了执行门静脉淋巴结切除术（第 8、12 和 13 站）时机器人方法的技术等效性，重点是模拟开放方法的回缩技术。在所介绍的病例中，计算机断层扫描显示，一名 40 岁女性患者有腔内胆囊肿块，并伴有门静脉周围淋巴结。患者接受了 RRC 门静脉淋巴结切除术，在 DaVinci Xi 机器人系统上进行。手术可分为五个主要步骤：（1）主动脉腔间区域16b1站节点采样； (2) 右门淋巴结清扫术（13、12b、12p 站）； (3) 左门淋巴结清扫术（8a、8p、12a、12p 站）； (4) 门静脉前淋巴结清扫术（12a、12b 站）； (5) 胆囊切除术联合肝楔形切除术。将每个步骤的技术细微差别与开放方法中的对应步骤进行比较，以证明其等效性。实现彻底肿瘤清除的关键要素是通过使用血管胶带进行门静脉淋巴结切除术，在机器人平台上复制开放式方法的牵开技术。RRC 的可行性和术后早期益处毫无疑问。2 该视频演示了机器人门淋巴结切除术和肝楔形切除术的标准化技术与开放手术的等效性。然而，需要进行前瞻性研究来进一步评估该手术的长期益处。© 2024。作者。

Open radical cholecystectomy is the current "gold standard" for the management of gallbladder cancer. In well-selected patients, robotic radical cholecystectomy (RRC) can be a suitable alternative offering immediate postoperative benefits, such as less blood loss, shorter hospital stay, and fewer complications, while being oncologically equivalent. However, it requires a longer learning curve.1 METHODS: This video demonstrates the technical equivalence of the robotic approach when performing portal lymphadenectomy (station 8, 12, and 13) with emphasis on retraction techniques to emulate the open approach. In the case presented, a 40-year-old female patient had an intraluminal gallbladder mass with periportal nodes as revealed by computed tomography. Patient underwent a RRC with portal lymphadenectomy, performed on the DaVinci Xi robotic system. The surgery can be divided into five major steps: (1) Station 16b1 node sampling in the inter-aortocaval region; (2) Right portal lymphadenectomy (station 13, 12b, 12p); (3) Left portal lymphadenectomy (station 8a, 8p, 12a, 12p); (4) Anterior portal lymphadenectomy (station 12a, 12b); and (5) Cholecystectomy with liver wedge resection. The technical nuances of each of these steps is compared with its counterpart in the open approach to demonstrate equivalence. The key element in achieving a thorough oncological clearance is to replicate the retraction techniques of the open approach on the robotic platform by using vessel tapes for portal lymphadenectomy.There remains little doubt regarding the feasibility and early postoperative benefits of RRC.2 This video demonstrates the equivalence of a standardized technique of robotic portal lymphadenectomy and liver wedge resection to the open approach. However, prospective studies are needed to further evaluate the long-term benefits of the procedure.© 2024. The Author(s).