Background : Gallbladder cancer is the most common malignant tumor of biliary system. The only potentially curative option for patients with gallbladder cancer is radical resection. We aim to describe the robotic radical cholecystectomy with segment 4b and 5 resection in a locally advanced gallbladder cancer.

Methods : A 46-year gentleman presented with dull aching right hypochondrial pain for 1 month. His per abdomen examination, liver function and renal function tests were normal. CECT abdomen showed locally advanced mass in gallbladder infiltrating segment 4b and 5. With this he was diagnosed to have locally advanced gallbladder carcinoma. Robotic radical cholecystectomy was contemplated with lymphadenectomy. Staging laparoscopy no evidence of intra-abdominal metastasis was found. Cystic duct arose from right hepatic duct. Frozen section of cystic duct showed no evidence of malignancy. Segment 4b and 5 of liver resected with CUSA and bipolar diathermy. A right sub hepatic drain was placed.

Results : The procedure was successfully completed in 320 min.Blood loss was 150 ml. There were no intraoperative complications and drain was removed on postoperative day 5,and then discharged on the same day. Histopathology report revealed – moderately differentiated squamous cell carcinoma with no malignancy in 7 lymph nodes examined (pT3N0M0). He was subjected for adjuvant therapy. On 1-year follow-up he had no recurrence.

Conclusions : The robotic radical cholecystectomy in locally advanced carcinoma gallbladder is safe and feasible. With robotic surgery system well suited for subtle dissections in a deep and narrow space, this has the potential to be viable.