Laparoscopic hepatectomy for benign liver tumors.

We describe our initial experience with videolaparoscopic hepatectomies. From November 1997 to May 1999, 6 female patients whose ages ranged from 36 to 71 years with hepatic benign tumors were submitted to laparoscopic hepatectomy. Three patients had hepatic adenomas, 1 non-parasitic cyst, 1 focal nodular hyperplasia and 1 hemangioma. The laparoscopy was performed under general anesthesia with a pneumoperitoneum of carbonic gas. The following were used: 0 degree and 30 degrees optics, 5, 10 e 12-mm trochars, a ring forceps, dissecting forceps, simple grasping forceps, curved scissors, mono- and bipolar cautery, endoscopic clip and vascular stapler. No ultrasonic scalpel or argonium coagulation were used. The surgical specimens were removed through a Pfannenstiel incision around 4-5 cm long, for a better anatomopathological evaluation. The surgical time ranged from 3 hours to 4 hours and 30 minutes. One patient had a prolonged ileus during the immediate postoperative period. Only a single patient had an abdominal drain. The time of hospitalization ranged from 2 to 7 days. No complications were observed in relation to the pneumoperitoneum. No deaths occurred in this series. In this way, laparoscopic hepatectomy may be an alternative approach in carefully selected patients.