Stefan Heinrich1, Daniel Seehofer2, Florian Corvinus1, Verena Tripke1, Tobias Huber1, Florentine Hüttl1, Lea Penzkofer1, Jens Mittler1, Mohammad Abu Hilal3, Hauke Lang4. 1. Klinik f. Allgemein‑, Viszeral- u. Transplantationschirurgie, Universitätsmedizin Mainz, Langenbeckstraße 1, 55131, Mainz, Deutschland. 2. Klinik u. Poliklinik für Viszeral‑, Transplantations‑, Thorax- und Gefäßchirurgie, Universitätsklinikum Leipzig, Leipzig, Deutschland. 3. Department of Surgery, Fondazione Poliambulanza Istituto Ospedaliero Multispecialistico, Brescia, Italien. 4. Klinik f. Allgemein‑, Viszeral- u. Transplantationschirurgie, Universitätsmedizin Mainz, Langenbeckstraße 1, 55131, Mainz, Deutschland. hauke.lang@unimedizin-mainz.de.
Abstract
BACKGROUND: Laparoscopic liver surgery (LLS) is increasingly utilized worldwide due to several potential advantages over open liver surgery. OBJECTIVE: Analysis and presentation of the advantages and disadvantages of LLS in comparison to open surgery. MATERIAL AND METHODS: Analysis of clinically relevant factors of minimally invasive liver surgery in comparison to open liver surgery in the current literature. RESULTS: In addition to obvious cosmetic advantages, the current literature shows advantages regarding length of hospital stay and quality of life after LLC. In contrast to major liver resections, parenchyma-preserving resections often appear cost-neutral due a shorter postoperative hospital stay compared to conventional liver resections. In addition to particular personnel requirements, LLS also has technical prerequisites, such as a dedicated intraoperative ultrasound system. Furthermore, contrast-enhanced laparoscopic examinations are possible and ultrasound information can be fused with preoperative imaging. Virtual reality technology and 3‑dimensional printing are currently under investigation to improve the intraoperative anatomical orientation of LLS. CONCLUSION: The current literature reveals significant advantages for LLS so that this procedure should be further developed in Germany in order to offer this technique to as many patients as possible.
BACKGROUND: Laparoscopic liver surgery (LLS) is increasingly utilized worldwide due to several potential advantages over open liver surgery. OBJECTIVE: Analysis and presentation of the advantages and disadvantages of LLS in comparison to open surgery. MATERIAL AND METHODS: Analysis of clinically relevant factors of minimally invasive liver surgery in comparison to open liver surgery in the current literature. RESULTS: In addition to obvious cosmetic advantages, the current literature shows advantages regarding length of hospital stay and quality of life after LLC. In contrast to major liver resections, parenchyma-preserving resections often appear cost-neutral due a shorter postoperative hospital stay compared to conventional liver resections. In addition to particular personnel requirements, LLS also has technical prerequisites, such as a dedicated intraoperative ultrasound system. Furthermore, contrast-enhanced laparoscopic examinations are possible and ultrasound information can be fused with preoperative imaging. Virtual reality technology and 3‑dimensional printing are currently under investigation to improve the intraoperative anatomical orientation of LLS. CONCLUSION: The current literature reveals significant advantages for LLS so that this procedure should be further developed in Germany in order to offer this technique to as many patients as possible.
Authors: Go Wakabayashi; Daniel Cherqui; David A Geller; Joseph F Buell; Hironori Kaneko; Ho Seong Han; Horacio Asbun; Nicholas OʼRourke; Minoru Tanabe; Alan J Koffron; Allan Tsung; Olivier Soubrane; Marcel Autran Machado; Brice Gayet; Roberto I Troisi; Patrick Pessaux; Ronald M Van Dam; Olivier Scatton; Mohammad Abu Hilal; Giulio Belli; Choon Hyuck David Kwon; Bjørn Edwin; Gi Hong Choi; Luca Antonio Aldrighetti; Xiujun Cai; Sean Cleary; Kuo-Hsin Chen; Michael R Schön; Atsushi Sugioka; Chung-Ngai Tang; Paulo Herman; Juan Pekolj; Xiao-Ping Chen; Ibrahim Dagher; William Jarnagin; Masakazu Yamamoto; Russell Strong; Palepu Jagannath; Chung-Mau Lo; Pierre-Alain Clavien; Norihiro Kokudo; Jeffrey Barkun; Steven M Strasberg Journal: Ann Surg Date: 2015-04 Impact factor: 12.969