BACKGROUND: Since the first laparoscopic cholecystectomy was performed in 1987, the surgical applications of laparoscopy have grown to involve most areas of general surgery. Until recently, however, major liver surgery remained outside of the scope of minimally invasive surgery. Building on advances in laparoscopic equipment, techniques, and ongoing experience in hepatic surgery, major liver resection has been performed laparoscopically in some select centers. At our institute, a safe and standardized approach to minimally invasive major hepatectomy has been developed. This article illustrates the relevant technical maneuvers in the performance of a totally laparoscopic right hepatectomy. Common pitfalls and areas of concern are discussed. METHODS: A detailed description of a standardized procedure is presented. The technique was developed from a single-institution experience of 41 laparoscopic right hepatectomies performed in a tertiary care referral center for laparoscopic digestive surgery. The prevention of bleeding and gas embolism are discussed. CONCLUSIONS: The laparoscopic right hepatectomy is feasible and safe if the appropriate expertise and equipment are available. In selected patients, this new approach can be proposed by a surgeon experienced in laparoscopic and hepatic surgery as an alternative to conventional open liver resection.
BACKGROUND: Since the first laparoscopic cholecystectomy was performed in 1987, the surgical applications of laparoscopy have grown to involve most areas of general surgery. Until recently, however, major liver surgery remained outside of the scope of minimally invasive surgery. Building on advances in laparoscopic equipment, techniques, and ongoing experience in hepatic surgery, major liver resection has been performed laparoscopically in some select centers. At our institute, a safe and standardized approach to minimally invasive major hepatectomy has been developed. This article illustrates the relevant technical maneuvers in the performance of a totally laparoscopic right hepatectomy. Common pitfalls and areas of concern are discussed. METHODS: A detailed description of a standardized procedure is presented. The technique was developed from a single-institution experience of 41 laparoscopic right hepatectomies performed in a tertiary care referral center for laparoscopic digestive surgery. The prevention of bleeding and gas embolism are discussed. CONCLUSIONS: The laparoscopic right hepatectomy is feasible and safe if the appropriate expertise and equipment are available. In selected patients, this new approach can be proposed by a surgeon experienced in laparoscopic and hepatic surgery as an alternative to conventional open liver resection.
Authors: Gi Hong Choi; Sung Hoon Choi; Sung Hoon Kim; Ho Kyoung Hwang; Chang Moo Kang; Jin Sub Choi; Woo Jung Lee Journal: Surg Endosc Date: 2012-02-04 Impact factor: 4.584
Authors: S S Chopra; J Rump; S C Schmidt; F Streitparth; C Seebauer; G Schumacher; I Van der Voort; U Teichgräber Journal: Eur Radiol Date: 2009-04-07 Impact factor: 5.315
Authors: Joseph F Buell; Brice Gayet; Ho-Seong Han; Go Wakabayashi; Ki-Hun Kim; Giulio Belli; Robert Cannon; Bob Saggi; Hiro Keneko; Alan Koffron; Guy Brock; Ibrahim Dagher Journal: HPB (Oxford) Date: 2013-01-18 Impact factor: 3.647