Console surgeon-controlled suction and coagulation during robot-assisted hepatectomy: early clinical evaluation of new flexible suction/coagulation probe

Background We recently developed a novel flexible suction/coagulation probe to overcome the rigidity of conventional electrosurgical probes, enabling simultaneous suction and coagulation from the console in robotic surgery. Although feasible in robot-assisted gastrectomy, its performance remains unevaluated in robot-assisted hepatectomy, which requires frequent suction and reliable hemostasis.Methods This single-arm feasibility study included 12 consecutive patients undergoing robot-assisted hepatectomy using the probe, directly manipulated by the console surgeon for hemostasis during parenchymal transection. Surgical outcomes (operative time, estimated blood loss, device trouble, complications) were assessed. Surgeons completed a post-procedure questionnaire covering seven usability and performance domains on a 3-point Likert scale.Results Robotic procedures included left hepatectomy, segmentectomies, and partial resections. All procedures were completed successfully without conversion. Median operative time was 397.5 min (range, 256–678 min), and estimated blood loss was 110 mL (range, 0–320 mL). No device-related adverse events or complications occurred. Overall satisfaction was rated 'satisfactory' by 75% of surgeons, with 'unsatisfactory' ratings occurring only for suction efficiency (16.7%).Conclusions The flexible suction/coagulation probe appears to be a practical and clinically feasible option for robot-assisted hepatectomy. Although the suction efficiency requires further improvement, the device enables direct console surgeon-controlled suction and hemostasis during hepatic parenchymal transection.