Michael Weiss1,2, Christof Mittermair1,2, Eberhard Brunner1,2, Jan Schirnhofer1,2, Christian Obrist1,2, Katharina Pimpl1,2, Tobias Hell3, Helmut Weiss4,5. 1. Surgical Department, Saint John of God Hospital, Kajetanerplatz 1, 5010, Salzburg, Austria. 2. Teaching Hospital of the Paracelsus Private Medical University of Salzburg, Salzburg, Austria. 3. Department of Mathematics, University of Innsbruck, Innsbruck, Austria. 4. Surgical Department, Saint John of God Hospital, Kajetanerplatz 1, 5010, Salzburg, Austria. helmut.weiss@bbsalz.at. 5. Teaching Hospital of the Paracelsus Private Medical University of Salzburg, Salzburg, Austria. helmut.weiss@bbsalz.at.
Abstract
BACKGROUND: Single-incision laparoscopy (SIL) has been developed to reduce surgical trauma, whereas technical difficulties in bleeding control limit the broad acceptance for hepatectomy. A novel minimized invasive strategy combining inline radiofrequency pre-coagulation and transumbilical SIL is presented herein. METHODS: A cohort of 21 selected patients underwent transumbilical SIL hepatectomies (segmentectomies II-VI) utilizing inline radiofrequency pre-coagulation for hepatic transection (Habib 4X). Bleeding control, postoperative complications and positive resection margins in malignant diseases served as primary and secondary outcome parameters, respectively. RESULTS: Single-incision laparoscopy was successfully completed in all patients. A total of 33 segments were retrieved: mean resection time was 66 ± 35 min, including 11 anatomical (52.38%) and 10 non-anatomical (47.62%) resections. Sixteen patients (76.19%) underwent concomitant abdominal surgery. No substantial blood loss occurred. Neither additional staplers nor clips were necessary to control any bleeding or bile leakage. One pleural effusion counted for the only postoperative complication. Free margins could be achieved in all but one resection (12/13 patients with malignancies; 92.31%). Ninety-day mortality was zero. CONCLUSIONS: The combination of SIL and inline radiofrequency pre-coagulation proved to be a simple, efficacious and safe technique in minor hepatectomy.
BACKGROUND: Single-incision laparoscopy (SIL) has been developed to reduce surgical trauma, whereas technical difficulties in bleeding control limit the broad acceptance for hepatectomy. A novel minimized invasive strategy combining inline radiofrequency pre-coagulation and transumbilical SIL is presented herein. METHODS: A cohort of 21 selected patients underwent transumbilical SIL hepatectomies (segmentectomies II-VI) utilizing inline radiofrequency pre-coagulation for hepatic transection (Habib 4X). Bleeding control, postoperative complications and positive resection margins in malignant diseases served as primary and secondary outcome parameters, respectively. RESULTS: Single-incision laparoscopy was successfully completed in all patients. A total of 33 segments were retrieved: mean resection time was 66 ± 35 min, including 11 anatomical (52.38%) and 10 non-anatomical (47.62%) resections. Sixteen patients (76.19%) underwent concomitant abdominal surgery. No substantial blood loss occurred. Neither additional staplers nor clips were necessary to control any bleeding or bile leakage. One pleural effusion counted for the only postoperative complication. Free margins could be achieved in all but one resection (12/13 patients with malignancies; 92.31%). Ninety-day mortality was zero. CONCLUSIONS: The combination of SIL and inline radiofrequency pre-coagulation proved to be a simple, efficacious and safe technique in minor hepatectomy.
Authors: Christof Mittermair; Michael Weiss; Jan Schirnhofer; Eberhard Brunner; Katharina Fischer; Christian Obrist; Michael de Cillia; Vanessa Kemmetinger; Emanuel Gollegger; Tobias Hell; Helmut Weiss Journal: J Clin Med Date: 2021-01-20 Impact factor: 4.241
Authors: Christian Benzing; Felix Krenzien; Georgi Atanasov; Daniel Seehofer; Robert Sucher; Ricardo Zorron; Johann Pratschke; Moritz Schmelzle Journal: GMS Interdiscip Plast Reconstr Surg DGPW Date: 2015-12-15