eISSN: 2299-0054
ISSN: 1895-4588
Videosurgery and Other Miniinvasive Techniques
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3/2018
vol. 13
 
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abstract:
Original paper

Comparison of resection site of standardized laparoscopic hepatic tumor resection

Yoshihiro Inoue, Masatsugu Ishii, Yusuke Tsuchimoto, Shinsuke Masubuchi, Masashi Yamamoto, Akira Asai, Shinya Fukunishi, Fumitoshi Hirokawa, Kazuhide Higuchi, Kazuhisa Uchiyama

Videosurgery Miniinv 2018; 13 (3): 333–341
Online publish date: 2018/05/21
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Introduction
The degree of difficulty in laparoscopic hepatic resection (LHR) was higher in tumors involving the suprahepatic segments than other sites. However, thanks to surgical instruments and procedures being improved and standardized, LHR can be performed safely in all regions.

Aim
We report our standardized surgical techniques and outcomes in a series of patients undergoing LHR in our hospital and analyze the surgical outcomes, particularly with regard to the site of resection.

Material and methods
We retrospectively analyzed data from 238 patients who underwent standardized laparoscopic partial hepatic resection between 2010 and 2017. In standardized LHR, the operator formed a triangle with the laparoscope in the center, maintaining a co-axial position by changing the port where the laparoscope was inserted.

Results
Operative time for the resection of tumors of the right hepatic lobe was 202 ±92 min and 140 ±104 min for tumors of the left hepatic lobe (p = 0.0024); intraoperative blood loss was 80 ±170 ml and 19 ±127 ml, respectively (p = 0.0016). No differences were found in the surgical outcomes between the various segments of the right hepatic lobe. In the left hepatic lobe, operative time was significantly shorter with laparoscopic tumor resection in segment III (p = 0.0023).

Conclusions
During standardized LHR, a better field of vision with the greater ease can be established during resection of the left hepatic lobe compared to that of the right hepatic lobe. Nonetheless, LHR of the right lobe can be performed safely using various surgical instruments and techniques.

keywords:

resection site, standardized laparoscopic hepatic resection, co-axial position, triangular formation, intercostal port, occlusion of the hepatic inflow

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