{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,10]],"date-time":"2026-07-10T17:12:47Z","timestamp":1783703567593,"version":"3.55.0"},"reference-count":40,"publisher":"MDPI AG","issue":"24","license":[{"start":{"date-parts":[[2024,12,21]],"date-time":"2024-12-21T00:00:00Z","timestamp":1734739200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: In Japan, the hinotori\u2122 surgical robot system (Medicaroid Corporation, Kobe, Japan) was approved for gastrointestinal surgeries in October 2022. This report details our initial experience performing liver resection using the hinotori\u2122 system. Methods: Ten patients, who were assessed as cases that would benefit from the robot-assisted procedure, underwent liver resections using the hinotori\u2122 system at Fujita Health University, Okazaki Medical Center, between August 2023 and October 2024. The backgrounds (patient, tumor, and liver function conditions, along with types of liver resections and previous surgical procedures) and short-term outcomes (operation time, blood loss, postoperative complications, open conversion, length of hospital stay, and mortality) of the cases were evaluated. Results: Eight cases of partial liver resection, one extended left medial sectionectomy, and one left hemi-hepatectomy were performed. Six cases of hepatocellular carcinomas, three cases of liver metastases, and one case of hepatolithiasis were included. There were seven male and three female patients with a median age of 70 years. Three physical status class III and seven class II patients were included. The median body mass index was 24. Five patients had previous upper abdominal surgical histories and five patients had liver cirrhosis. The median operation time was 419.5 min, and the median intraoperative blood loss was 276 mL. An open conversion in one hepatocellular carcinoma case was carried out due to bleeding from collateral vessels in the round ligament. The median length of hospital stay was 7.5 days. A grade IIIa complication (delayed bile leakage) was developed in one case. All patients with tumors underwent R0 resection. There were no cases of mortality. Conclusions: Liver resection using the hinotori\u2122 system was feasibly performed. This study reports the first global use of the hinotori\u2122 system for liver resection.<\/jats:p>","DOI":"10.3390\/jcm13247819","type":"journal-article","created":{"date-parts":[[2024,12,23]],"date-time":"2024-12-23T10:58:55Z","timestamp":1734951535000},"page":"7819","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["The First Report on Liver Resection Using the Novel Japanese hinotori\u2122 Surgical Robot System: First Case Series Report of 10 Cases"],"prefix":"10.3390","volume":"13","author":[{"given":"Kenichi","family":"Nakamura","sequence":"first","affiliation":[{"name":"Department of Surgery, Fujita Health University Okazaki Medical Center, 1 Gotanda, Harisaki-cho, Okazaki 444-0827, Aichi, Japan"},{"name":"Department of Surgery, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake 470-1192, Aichi, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tetsuya","family":"Koide","sequence":"additional","affiliation":[{"name":"Department of Surgery, Fujita Health University Okazaki Medical Center, 1 Gotanda, Harisaki-cho, Okazaki 444-0827, Aichi, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takahiko","family":"Higashiguchi","sequence":"additional","affiliation":[{"name":"Department of Surgery, Fujita Health University Okazaki Medical Center, 1 Gotanda, Harisaki-cho, Okazaki 444-0827, Aichi, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuhiro","family":"Matsuo","sequence":"additional","affiliation":[{"name":"Department of Surgery, Fujita Health University Okazaki Medical Center, 1 Gotanda, Harisaki-cho, Okazaki 444-0827, Aichi, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomoyoshi","family":"Endo","sequence":"additional","affiliation":[{"name":"Department of Surgery, Fujita Health University Okazaki Medical Center, 1 Gotanda, Harisaki-cho, Okazaki 444-0827, Aichi, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenji","family":"Kikuchi","sequence":"additional","affiliation":[{"name":"Department of Surgery, Fujita Health University Okazaki Medical Center, 1 Gotanda, Harisaki-cho, Okazaki 444-0827, Aichi, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-9634-2980","authenticated-orcid":false,"given":"Koji","family":"Morohara","sequence":"additional","affiliation":[{"name":"Department of Surgery, Fujita Health University Okazaki Medical Center, 1 Gotanda, Harisaki-cho, Okazaki 444-0827, Aichi, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hidetoshi","family":"Katsuno","sequence":"additional","affiliation":[{"name":"Department of Surgery, Fujita Health University Okazaki Medical Center, 1 Gotanda, Harisaki-cho, Okazaki 444-0827, Aichi, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ichiro","family":"Uyama","sequence":"additional","affiliation":[{"name":"Department of Surgery, Fujita Health University Okazaki Medical Center, 1 Gotanda, Harisaki-cho, Okazaki 444-0827, Aichi, Japan"},{"name":"Department of Advanced Robotic and Endoscopic Surgery, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake 470-1192, Aichi, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koichi","family":"Suda","sequence":"additional","affiliation":[{"name":"Department of Surgery, Fujita Health University, 1-98 Dengakugakubo, Kutsukake, Toyoake 470-1192, Aichi, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6382-6502","authenticated-orcid":false,"given":"Zenichi","family":"Morise","sequence":"additional","affiliation":[{"name":"Department of Surgery, Fujita Health University Okazaki Medical Center, 1 Gotanda, Harisaki-cho, Okazaki 444-0827, Aichi, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,12,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"156","DOI":"10.1186\/s40792-023-01705-9","article-title":"World-first report of low anterior resection for rectal cancer with the hinotori\u2122 Surgical Robot System: A case report","volume":"9","author":"Miura","year":"2023","journal-title":"Surg. Case Rep."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"604","DOI":"10.1111\/ases.13197","article-title":"Right hemicolectomy for ascending colon cancer using the hinotori surgical robot system: The first ever case report for colon cancer","volume":"16","author":"Miyo","year":"2023","journal-title":"Asian J. Endosc. Surg."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"101974","DOI":"10.1016\/j.suronc.2023.101974","article-title":"Robotic distal pancreatectomy using a docking-free system (the hinotori\u2122 Surgical Robot System)","volume":"50","author":"Ide","year":"2023","journal-title":"Surg. Oncol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1626","DOI":"10.1007\/s00464-024-10695-0","article-title":"First clinical experiences of robotic gastrectomy for gastric cancer using the hinotori\u2122 surgical robot system","volume":"38","author":"Inoue","year":"2024","journal-title":"Surg. Endosc."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1186\/s12957-024-03499-y","article-title":"A new era in surgical oncology: Preliminary insights into the hinotori\u2122 surgical robot system\u2019s role in rectal surgery using the double bipolar method","volume":"22","author":"Katsuno","year":"2024","journal-title":"World J. Surg. Oncol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"e13349","DOI":"10.1111\/ases.13349","article-title":"Robotic gastrectomy using hinotori\u2122 Surgical Robot System: Initial case series","volume":"17","author":"Kitadani","year":"2024","journal-title":"Asian J. Endosc. Surg."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"e13385","DOI":"10.1111\/ases.13385","article-title":"First report of surgery for congenital biliary dilatation using the hinotori\u2122 Surgical Robot System (with video)","volume":"17","author":"Okui","year":"2024","journal-title":"Asian J. Endosc. Surg."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"3929","DOI":"10.1007\/s00464-024-10918-4","article-title":"Introduction of a new surgical robot platform \u201chinotori\u2122\u201d in an institution with established da Vinci surgery\u2122 for digestive organ operations","volume":"38","author":"Noshiro","year":"2024","journal-title":"Surg. Endosc."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1186\/s40792-024-01808-x","article-title":"Robotic spleen-preserving distal pancreatectomy using the first domestic surgical robot platform (the hinotori\u2122 Surgical Robot System): A case report","volume":"10","author":"Tomihara","year":"2024","journal-title":"Surg. Case Rep."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"e2648","DOI":"10.1002\/rcs.2648","article-title":"Radical prostatectomy using the Hinotori robot-assisted surgical system: Docking-free design may contribute to reduction in postoperative pain","volume":"20","author":"Sasaki","year":"2024","journal-title":"Int. J. Med. Robot. + Comput. Assist. Surg. MRCAS"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1034","DOI":"10.1093\/jjco\/hyad105","article-title":"The first report of surgery for gynecological diseases using the hinotori\u2122 surgical robot system","volume":"53","author":"Togami","year":"2023","journal-title":"Jpn. J. Clin. Oncol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"5537","DOI":"10.3390\/curroncol31090410","article-title":"Retzius-Sparing Robot-Assisted Radical Prostatectomy Using the Hinotori Surgical Robot System Platform: Report of the First Series of Experiences","volume":"31","author":"Yamada","year":"2024","journal-title":"Curr. Oncol."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Morise, Z., Kawabe, N., Tomishige, H., Nagata, H., Kawase, J., Arakawa, S., and Isetani, M. (2015). How Far Can We Go with Laparoscopic Liver Resection for Hepatocellular Carcinoma? Laparoscopic Sectionectomy of the Liver Combined with the Resection of the Major Hepatic Vein Main Trunk. BioMed Res. Int., 2015.","DOI":"10.1155\/2015\/960752"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"298","DOI":"10.1002\/ssu.2980090404","article-title":"Surgery for small liver cancers","volume":"9","author":"Makuuchi","year":"1993","journal-title":"Semin. Surg. Oncol."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Morise, Z. (2024). Revisiting the Institut Mutualiste Montsouris Difficulty Classification of Laparoscopic Liver Resection with the Data from a Personal Series-Evaluations for the Difficulty of Left Medial Sectionectomy and Length of Hospital Stay. J. Pers. Med., 14.","DOI":"10.3390\/jpm14030232"},{"key":"ref_16","first-page":"108","article-title":"Robotic Versus Laparoscopic Liver Resection in Various Settings: An International Multicenter Propensity Score Matched Study of 10.075 Patients","volume":"280","author":"Sijberden","year":"2024","journal-title":"Ann. Surg."},{"key":"ref_17","first-page":"297","article-title":"Propensity Score-Matching Analysis Comparing Robotic Versus Laparoscopic Limited Liver Resections of the Posterosuperior Segments: An International Multicenter Study","volume":"279","author":"Krenzien","year":"2024","journal-title":"Ann. Surg."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"e1269","DOI":"10.1097\/SLA.0000000000005600","article-title":"Implementation and Outcome of Robotic Liver Surgery in the Netherlands: A Nationwide Analysis","volume":"277","author":"Zwart","year":"2023","journal-title":"Ann. Surg."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1062","DOI":"10.1016\/j.hpb.2024.05.013","article-title":"Multicenter propensity score-matched analysis to compare perioperative morbidity after laparoscopic or robotic complex hepatectomy for solitary hepatocellular carcinoma","volume":"26","author":"Huang","year":"2024","journal-title":"HPB (Oxf.)"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"2241","DOI":"10.1007\/s00268-023-07060-y","article-title":"Robotic Versus Laparoscopic Hepatectomy: A Single Surgeon Experience of 629 Consecutive Minimally Invasive Liver Resections","volume":"47","author":"Winckelmans","year":"2023","journal-title":"World J. Surg."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1001\/jamasurg.2022.5697","article-title":"Safety and Efficacy of Robotic vs Open Liver Resection for Hepatocellular Carcinoma","volume":"158","author":"Magistri","year":"2023","journal-title":"JAMA Surgery"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"5854","DOI":"10.1007\/s00464-021-08770-x","article-title":"Robotic vs. laparoscopic liver surgery: A single-center analysis of 600 consecutive patients in 6 years","volume":"36","author":"Schmelzle","year":"2022","journal-title":"Surg. Endosc."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"6724","DOI":"10.1007\/s00464-021-08948-3","article-title":"Propensity score matched comparison of robotic and open major hepatectomy for malignant liver tumors","volume":"36","author":"Sucandy","year":"2022","journal-title":"Surg. Endosc."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"1271","DOI":"10.1007\/s12072-024-10658-6","article-title":"Efficacy and safety of robotic versus laparoscopic liver resection for hepatocellular carcinoma: A propensity score-matched retrospective cohort study","volume":"18","author":"Li","year":"2024","journal-title":"Hepatol. Int."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"e70003","DOI":"10.1002\/rcs.70003","article-title":"Short-Term Surgical Outcomes After Robotic Liver Surgery: A Propensity-Score Matched Analysis With Conventional Open Liver Surgery at a High-Volume Centre in Denmark","volume":"20","author":"Fukumori","year":"2024","journal-title":"Int. J. Med. Robot. Comput. Assist. Surg."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1007\/s00423-024-03239-6","article-title":"Results of robotic liver surgery in association with IWATE criteria\u2014The first 100 cases","volume":"409","author":"Steinkraus","year":"2024","journal-title":"Langenbeck\u2019s Arch. Surg."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"2000","DOI":"10.1007\/s00464-019-06976-8","article-title":"Robotic versus laparoscopic hepatectomy: Application of the difficulty scoring system","volume":"34","author":"Chong","year":"2020","journal-title":"Surg. Endosc."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"8","DOI":"10.14701\/ahbps.2021.25.1.8","article-title":"Robotic major liver resections: Surgical outcomes compared with open major liver resections","volume":"25","author":"Yang","year":"2021","journal-title":"Ann. Hepato-Biliary-Pancreat. Surg."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"5855","DOI":"10.1007\/s00464-023-10051-8","article-title":"Robotic versus laparoscopic liver resections for hepatolithiasis: An international multicenter propensity score matched analysis","volume":"37","author":"Kwak","year":"2023","journal-title":"Surg. Endosc."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"4728","DOI":"10.1007\/s00464-023-09952-5","article-title":"Robotic versus laparoscopic liver resection in posterosuperior region: A retrospective study of consecutive cases","volume":"37","author":"Chen","year":"2023","journal-title":"Surg. Endosc."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"100972","DOI":"10.1016\/j.lanepe.2024.100972","article-title":"Robotic versus laparoscopic hepatectomy for liver malignancies (ROC\u2019N\u2019ROLL): A single-centre, randomised, controlled, single-blinded clinical trial","volume":"43","author":"Birgin","year":"2024","journal-title":"Lancet Reg. Health Eur."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"160","DOI":"10.1097\/EJA.0000000000000366","article-title":"Current issues in postoperative pain management","volume":"33","author":"Rawal","year":"2016","journal-title":"Eur. J. Anaesthesiol."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1007\/s00464-023-10561-5","article-title":"Robotic versus laparoscopic liver resection for liver malignancy: A systematic review and meta-analysis of propensity score-matched studies","volume":"38","author":"Long","year":"2024","journal-title":"Surg. Endosc."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"290","DOI":"10.1177\/1457496920925637","article-title":"Robotic versus conventional laparoscopic liver resections: A systematic review and meta-analysis","volume":"110","author":"Kamarajah","year":"2021","journal-title":"Scand. J. Surg."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"4815","DOI":"10.3748\/wjg.v29.i32.4815","article-title":"International experts consensus guidelines on robotic liver resection in 2023","volume":"29","author":"Liu","year":"2023","journal-title":"World J. Gastroenterol."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"889","DOI":"10.1002\/bjs.11436","article-title":"Laparoscopic repeat liver resection for hepatocellular carcinoma: A multicentre propensity score-based study","volume":"107","author":"Morise","year":"2020","journal-title":"Br. J. Surg."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"3783","DOI":"10.1007\/s00423-022-02710-6","article-title":"Establishment of a new practical telesurgical platform using the hinotori\u2122 Surgical Robot System: A preclinical study","volume":"407","author":"Nakauchi","year":"2022","journal-title":"Langenbeck\u2019s Arch. Surg."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1653","DOI":"10.1007\/s00595-022-02497-5","article-title":"Tele-assessment of bandwidth limitation for remote robotics surgery","volume":"52","author":"Ebihara","year":"2022","journal-title":"Surg. Today"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1111\/ases.13150","article-title":"Verification of delay time and image compression thresholds for telesurgery","volume":"16","author":"Takahashi","year":"2023","journal-title":"Asian J. Endosc. Surg."},{"key":"ref_40","doi-asserted-by":"crossref","unstructured":"Teishima, J., Wakita, N., Bando, Y., Okamura, Y., Suzuki, K., Hara, T., Terakawa, T., Chiba, K., Matsushita, K., and Nakano, Y. (2024). Effects of modifying hinotori\u2122 surgical robot system on perioperative outcome of robot-assisted radical prostatectomy. Int. J. Urol.","DOI":"10.1111\/iju.15593"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/24\/7819\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T16:57:21Z","timestamp":1760115441000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/13\/24\/7819"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12,21]]},"references-count":40,"journal-issue":{"issue":"24","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["jcm13247819"],"URL":"https:\/\/doi.org\/10.3390\/jcm13247819","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,12,21]]}}}