Laparoscopic liver resection

Abstract

In experienced hands, the results of laparoscopic liver surgery are similar to those for laparotomy.

Tissue Management With Tri-Staple Technology in Major and Minor Laparoscopic Liver Resections

“…The tan, mostly ''curved'' type Covidien Endo GIA Reloads (compressed tissue thickness range, 0.88-1.8 mm) were used. The median number of cartridges per patient was 2 (range, [1][2][3][4][5][6][7][8][9]. Differences between the groups are depicted in Table 3.…”

“…[1][2][3][4][5][6][7] Meticulous knowledge of surgical anatomy of the liver, improvements in perioperative care, development of newer instruments, enhanced diagnostic imaging, and advancement in laparoscopic skills are considered the major advances that have been achieved in this field.…”

Laparoscopic Liver Surgery

“…A few series are dedicated to LLR for benign tumours only but these can be subdivided into solid or cystic 19 20 . Most studies report outcomes in series mixed for both benign and malignant tumours 21 . The largest series of LLR for benign tumours have been reported by Koffron et al (n=177) 22 .…”

“…This is as a result of the two dimensional view during laparoscopy and the ergonomics of most laparoscopic instruments make this manipulation blind with the potential of injury to vital structures. Most of the literature on totally laparoscopic liver resection mentions the placement of a tape or vascular sling around the portal triad in the hepato-duodenal ligament in case a Pringle's manoeuvre is necessary during parenchymal division 21 although opinions differ 65 14 66 and once experience has been gained for minor resections is often not necessary at all, even in some cirrhotic patients 67 Nonetheless it is our policy to always place a tape around the hepatoduodenal ligament for training purposes. Some surgeons use a tape around the hepato-duodenal ligament with intra-peritoneal clamping.…”

Ressecção laparoscópica do segmento lateral esquerdo do fígado em doador para transplante hepático inter-vivos

“…Em um estudo com 89 casos de operações hepáti-cas laparoscópicas, a indicação do procedimento foi a ressecção de metástases de neoplasia de cólon em 46%; ressecção de doença benigna, como cisto hidático e hemangioma em 27%; carcinoma hepatocelular com cirrose associada em 9%; carcinoma hepatocelular sem cirrose associada em 9% e outras neoplasias em 9% 1 . Somente em 42% dos casos foram realizadas hepatectomias anatômicas, no restante operações hepáticas menores.…”