Laparoscopic liver resection: the current status and the future

Cai, Xiujun

doi:10.21037/hbsn.2018.02.07

Cited by 49 publications

(41 citation statements)

References 45 publications

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“…Anatomic hepatectomy is bene cial for patients with HCC in terms of the recurrence-free survival rate compared with non-anatomic hepatectomy in open surgery, although it may increase the operation time [16][17][18][19][20] . Because anatomic hepatectomy is based on the in ow and out ow corresponding to the target lobe or segment, the root of the Glisson pedicle and hepatic vein can serve as an extrahepatic landmark, while the major hepatic vein can serve as an intrahepatic boundary.…”

Section: Discussionmentioning

confidence: 99%

Dorsal approach with Glissonian approach in laparoscopic anatomic hepatectomy for right lobe

Wang

Yang

Zhang

et al. 2020

Preprint

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Background Laparoscopic anatomic hepatectomy (LAH) has gradually become a routine surgical procedure. We previously reported that Glissonian approach combined with major hepatic vein first was effective for LAH. Because dorsal approach could effectively expose the major hepatic vein, we merged it with Glissonian approach in LAH for the right lobe. Methods Twenty patients who underwent LAH from January 2017 to November 2018 were retrospectively analysed. Of these patients, seven patients underwent laparoscopic right hemihepatectomy (LRH group), seven patients who underwent laparoscopic right posterior hepatectomy (LRPH group), and six patients who underwent laparoscopic hepatectomy for segment 7 (LS7 group). First, the paracaval portion of caudate lobe along the IVC was transected through dorsal approch after the corresponding hepatic pedicles were isolated through Glissonian approach. Next, the liver parenchyma was transected by dorsal approach until the corresponding major hepatic vein was exposed from its trunk to the root. Then, the liver parenchyma was transected by a ventral approach. Finally, the root of the major hepatic vein was transected. Results The mean age of the patients was 53.8 years and the male: female ratio was 8:12. The median operation time was 306.0 ± 58.2 min and the mean estimated volume of blood loss was 412.5 ± 255.4 mL. The mean duration of postoperative hospital stay was 10.2 days. The mean Pringle maneuver time was 64.8 ± 27.7 min. Five patients received transfusion of 2–4 U of red blood cells. Two patients suffered from transient hepatic dysfunction and one suffered from pleural effusion. None of the patients underwent conversion to an open procedure. The operative duration, volume of the blood loss, Pringle maneuver time, and postoperative hospital stay duration did not differ significantly among the LRH, LRPH, and LS7 groups (P > 0.05). Conclusion Dorsal approach combined with Glissonian approach for right lobe in LAH is feasible and effective, although it is essential to include more cases for further study.

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Section: Discussionmentioning

confidence: 99%

Dorsal approach with Glissonian approach in laparoscopic anatomic hepatectomy for right lobe

Wang

Yang

Zhang

et al. 2020

Preprint

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“…5,6 Evermore, laparoscopic liver surgery expanded to include hemi-hepatectomy, sectionectomy, segmentectomy, and recently, parenchymal preserving and modified anatomical resections, mirroring the technological, as well as, the conceptual advances in liver surgery. 7,8…”

Section: Introductionmentioning

confidence: 99%

The role of robotics in liver surgery

Rai

Lin

2019

Int Surg J

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Laparoscopic surgery has become a staple in many tertiary care centres worldwide. However, due to the inherent limitations of laparoscopic surgery, adoption of minimal access approaches in surgery of the liver has been slow and patchy. Every hepatobiliary surgeon knows the limitations of laparoscopic surgery of the liver. Advanced robotic surgical systems have been introduced to fill gaps in the technical feasibility of minimal access liver resections We try to explore the use of advanced robotic systems in hepatobiliary surgery and how the novel system could help circumvent the inherent limitations of laparoscopic liver surgery. The manuscript reviews the current data concerning laparoscopic, as well as, open versus robotic approaches in liver surgery. Authors show that although robotic surgery is in its infancy, the promising role cannot be ignored. With the increasing trend towards parenchymal saving liver resection, robotics will only positively aid in the wider adoption and growth of minimally invasive techniques. Although robotics is still evolving, the need in liver surgery is evident. Further long-term research is required, however, to confirm the huge potential of robotics in liver surgery.

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“…left lateral section (II-III) or anterior hepatic segments (IVb, V, VI) can be carried out through laparoscopic approach (1)(2)(3)(4)(5). Prominent healthcare centers offer hemihepatectomies, trisectionectomies and resections of posterosuperior segments (IVa, VII, VIII) and caudate (I), which are considered major liver resections (1,2,5). Major liver resections are seldom performed, even at leading centers, because of considerable technical complexities, risk of massive bleeding and positive tumor margins (1,2,5).…”

mentioning

confidence: 99%

“…Prominent healthcare centers offer hemihepatectomies, trisectionectomies and resections of posterosuperior segments (IVa, VII, VIII) and caudate (I), which are considered major liver resections (1,2,5). Major liver resections are seldom performed, even at leading centers, because of considerable technical complexities, risk of massive bleeding and positive tumor margins (1,2,5). Segment VII and VIII tumors can be hardly reached by currently available laparoscopic instruments (1).…”

mentioning

confidence: 99%