Using the da Vinci SP Surgical System for liver and stomach surgeries

Inclusion Criteria

Cholecystectomy Stage 1 - Inclusion Criteria:

* Patients between the ages of 18 and 80 years of age
* Either male or female
* BMI ≤ 26 kg/m2
* ASA ≤ 3
* Diagnosed with benign disease

Fundoplication Stage 1- Inclusion Criteria:

* Patients diagnosed with GERD and/or hiatal hernia
* Patients between the ages of 18 and 80 years of age
* Either men or women
* BMI ≤ 26 kg/m2
* ASA ≤ 3

Gastrectomy Stage 2- Inclusion Criteria:

* Patients between the ages of 18 and 80 years of age
* Either men or women
* BMI ≤ 26 kg/m2
* ASA ≤ 3
* Diagnosed with benign or relatively early malignant disease of the stomach
* AJCC 8th edition T0 or T1 tumor pathology
* AJCC 8th edition T2, T3, tumor pathology (following neoadjuvant therapy if necessary) at the discretion of the investigator
* Free of metastatic disease

Distal Pancreatectomy Stage 2- Inclusion Criteria:

* Patients between the ages of 18 and 80 years of age
* Either men or women
* BMI ≤ 26 kg/m2
* ASA ≤ 3
* Diagnosed with benign or malignant disease of the pancreas
* No vascular involvement
* Free of metastatic disease

Pancreaticoduodenectomy Stage 3- Inclusion Criteria:

* Patients between the ages of 18 and 80 years of age
* Either men or women
* BMI ≤ 26 kg/m2
* ASA ≤ 3
* Diagnosed with benign or malignant disease of the pancreas
* Diagnosed with benign or malignant distal bile duct disease
* No vasculature involvement (i.e., no T4 disease, pancreatic or Stage 4a or b disease, or distal bile duct Stage 3b or 4 disease)
* Free of metastatic disease

Esophagectomy Stage 3- Inclusion Criteria:

* Patients between the ages of 18 and 80 years of age
* Either men or women
* BMI ≤ 26 kg/m2
* ASA ≤ 3
* Diagnosed with benign or malignant disease of the esophagus
* AJCC 8th edition T0, T1a, T1b, T2 (without other indications for neoadjuvant therapy) tumor pathology
* AJCC 8th edition some T2, T3, or T4a, (following neoadjuvant therapy) at the discretion of the investigator
* Free of metastatic disease

Hepatectomy Stage 4- Inclusion Criteria:

* Patients between the ages of 18 and 80 years of age
* Either men or women
* BMI ≤ 26 kg/m2
* ASA ≤ 3
* Diagnosed with benign or malignant disease of the liver or bile duct
* Free of metastatic disease, not including metastatic disease to the liver (e.g., colorectal liver metastases)

Exclusion Criteria

Cholecystectomy Stage 1- Exclusion Criteria:

* Subject requiring an emergent operation
* Pregnancy or nursing
* BMI \> 26 kg/m2
* Previous abdominal surgery
* Subjects with malignant disease
* Inability to provide informed consent
* Contraindicated for general anesthesia or minimally invasive surgery

Fundoplication Stage 1- Exclusion Criteria:

* Subject requiring an emergent operation
* Pregnancy or nursing
* BMI \> 26 kg/m2
* Previous abdominal surgery
* Inability to provide informed consent
* Contraindicated for general anesthesia or minimally invasive surgery

Gastrectomy Stage 2- Exclusion Criteria:

* Subject requiring an emergency operation
* Pregnancy or nursing
* BMI \> 26 kg/m2
* Previous abdominal surgery
* Inability to provide informed consent
* Contraindicated for general anesthesia or minimally invasive surgery
* AJCC 8th edition T2, T3, T4a, T4b tumor pathology (without neoadjuvant therapy unless contraindicated)
* Clinical or radiological evidence of distant metastatic disease

Distal Pancreatectomy Stage 2- Exclusion Criteria:

* Subject requiring an emergent operation
* Pregnancy or nursing
* BMI \> 26 kg/m2
* Previous abdominal surgery
* Inability to provide informed consent
* Contraindicated for general anesthesia or minimally invasive surgery
* Tumor involvement with surrounding vasculature (e.g., common hepatic artery, superior mesenteric artery, superior mesenteric vein, portal vein)
* Clinical or radiological evidence of metastatic disease

Pancreaticoduodenectomy Stage 3- Exclusion Criteria:

* Subject requiring an emergent operation
* Pregnancy or nursing
* BMI \> 26 kg/m2
* Previous abdominal surgery
* Inability to provide informed consent
* Contraindicated for general anesthesia or minimally invasive surgery
* Tumor involvement with surrounding vasculature (e.g., T4a for pancreatic disease: common hepatic artery, superior mesenteric artery, superior mesenteric vein, portal vein)
* Tumor involvement with surrounding vasculature (e.g., T3b for bile duct disease: common hepatic artery, superior mesenteric artery, superior mesenteric vein, portal vein)
* Clinical or radiological evidence of metastatic disease

Esophagectomy Stage 3- Exclusion Criteria:

* Subject requiring an emergency operation
* Pregnancy or nursing
* BMI \> 26 kg/m2
* Previous abdominal surgery
* Inability to provide informed consent
* Contraindicated for general anesthesia or minimally invasive surgery
* AJCC 8th edition T2 (in some circumstances), T3, and T4a tumor pathology (without neoadjuvant therapy)
* Clinical or radiological evidence of distant metastatic disease

Hepatectomy Stage 4- Exclusion Criteria:

* Subject requiring an emergency operation
* Pregnancy or nursing
* BMI \> 26 kg/m2
* Previous abdominal surgery
* Inability to provide informed consent
* Contraindicated for general anesthesia or minimally invasive surgery
* Perihilar cholangiocarcinoma (i.e., Klatskin tumor)
* Involvement of major vasculature (ex: portal vein, hepatic artery, or inferior vena cava)
* Clinical or radiological evidence of metastatic disease