Milestones in the evolution of hepatic surgery

Bismuth, H; Eshkenazy, Rony; Arish, A.

doi:10.5041/rmmj.10021

Cited by 13 publications

(10 citation statements)

References 86 publications

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“…Liver surgery has developed significantly in the past decades. Comprehension about liver anatomy, development of parenchyma transection techniques, incorporation of new technologies and instruments made liver surgery a complex and effective specialty 5 , requiring structure available in tertiary centers 4 . In the last years, minimally invasive techniques were incorporated to liver surgery, adding a new set of complex operations to be learned and performed by liver surgeons 8 .…”

Section: Introductionmentioning

confidence: 99%

Liver Resection in Brazil: A National Survey

Fonseca

Jeismann

Krüger

et al. 2018

ABCD, arq. bras. cir. dig.

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Background:Liver surgery has developed significantly in the past decades. In Brazil, the interest on it has grown significantly, but there is no study regarding its clinical practice. Despite intrinsic limitations, surveys are well suited to descriptive studies and allow understanding the current scenario. Aim:To provide an overview on the current spread of liver surgery in Brazil, focusing on groups´ profile, operative techniques and availability of resources. Method:From May to November 2016, was conducted a national survey about liver surgery profile in Brazil composed by 28 questions concerning surgical team characteristics, technical preferences, surgical volume, results and available institutional resources. The survey was sent by e-mail to 84 liver surgery team leaders from different centers including all regions of the country. Results:Forty-three study participants (51.2%), from all Brazilian regions, responded the survey. Most centers have residency/fellowship programs (86%), perform and do laparoscopic procedures (91%); however, laparoscopy is still responsible for a little amount of surgeries (1-9% of laparoscopic procedures over all liver resections in 39.5% of groups). Only seven centers (16.3%) perform more than 50 liver resections/year. Postoperative mortality rate is between 1-3% in 55% of the centers. Conclusion:This is the first depiction of liver surgery in Brazil. It showed a surgical practice aligned with worldwide excellence centers, concentrated on hospitals dedicated to academic practice.

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Section: Introductionmentioning

confidence: 99%

Liver Resection in Brazil: A National Survey

Fonseca

Jeismann

Krüger

et al. 2018

ABCD, arq. bras. cir. dig.

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“…Moving ahead to modern times, the first liver resections were performed on patients with traumatic injuries resulting from combat in the seventeenth and eighteenth centuries. The first planned non-traumatic liver operation was performed in 1888 by Langenbuch [ 3 ]. The Australian surgeon Pringle introduced the maneuver for in-flow occlusion that carries his name in 1908.…”

Section: Liver Surgerymentioning

confidence: 99%

Laparoscopic and Robot-Assisted Hepatic Surgery: An Historical Review

Shimizu

Ito

Lefor

2022

JCM

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Hepatic surgery is a rapidly expanding component of abdominal surgery and is performed for a wide range of indications. The introduction of laparoscopic cholecystectomy in 1987 was a major change in abdominal surgery. Laparoscopic surgery was widely and rapidly adopted throughout the world for cholecystectomy initially and then applied to a variety of other procedures. Laparoscopic surgery became regularly applied to hepatic surgery, including segmental and major resections as well as organ donation. Many operations progressed from open surgery to laparoscopy to robot-assisted surgery, including colon resection, pancreatectomy, splenectomy thyroidectomy, adrenalectomy, prostatectomy, gastrectomy, and others. It is difficult to prove a data-based benefit using robot-assisted surgery, although laparoscopic and robot-assisted surgery of the liver are not inferior regarding major outcomes. When laparoscopic surgery initially became popular, many had concerns about its use to treat malignancies. Robot-assisted surgery is being used to treat a variety of benign and malignant conditions, and studies have shown no deterioration in outcomes. Robot-assisted surgery for the treatment of malignancies has become accepted and is now being used at more centers. The outcomes after robot-assisted surgery depend on its use at specialized centers, the surgeon’s personal experience backed up by extensive training and maintenance of international registries. Robot-assisted hepatic surgery has been shown to be associated with slightly less intraoperative blood loss and shorter hospital lengths of stay compared to open surgery. Oncologic outcomes have been maintained, and some studies show higher rates of R0 resections. Patients who need surgery for liver lesions should identify a surgeon they trust and should not be concerned with the specific operative approach used. The growth of robot-assisted surgery of the liver has occurred in a stepwise approach which is very different from the frenzy that was seen with the introduction of laparoscopic cholecystectomy. This approach allowed the identification of areas for improvement, many of which are at the nexus of engineering and medicine. Further improvements in robot-assisted surgery depend on the combined efforts of engineers and surgeons.

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“…Hepatic transection remained a challenge for all surgeons, for more than a century. The first scheduled hepatectomy was performed in 1888 from Carl Langenbuch [24]. Liver surgery was minimal thus, up to the 20th century, when Pringle maneuver was first presented, for bleeding control during emergency hepatic resections [14].…”

Section: Techniques Of Liver Parenchyma Transection For Hcc 71 Finger Fracture Techniquementioning

confidence: 99%

Surgical Therapy of Hepatocellular Carcinoma: State of the Art Liver Resection

Davakis¹,

Vailas²,

Kozadinos³

et al. 2022

Hepatocellular Carcinoma - Challenges and Opportunities of a Multidisciplinary Approach

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Hepatocellular carcinoma (HCC) represents the third most common cause of cancer-related death, showing incremental growth rates throughout the last decades. HCC requires multidisciplinary approach in a group of patients suffering from underlying chronic liver disease, usually in the setting of cirrhosis. The mainstay of treatment in resectable cases is surgery, with anatomic and non-anatomic liver resections widely implemented, as well as liver transplantation in well-selected individuals. Nowadays, there is a variety of liver parenchyma transection devices used by hepatobiliary surgeons in specialized centers, which has significantly improved postoperative outcomes in HCC patients. Therefore, hepatectomy is considered safe and feasible and should be the main therapeutic option for HCC patients, candidates for resection. Liver resection utilizing cavitron ultrasonic aspirator in combination with bipolar radiofrequency ablation is safe and effective for the treatment of HCC with favorable clinical and oncological outcomes.

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Milestones in the evolution of hepatic surgery

Cited by 13 publications

References 86 publications

Liver Resection in Brazil: A National Survey

Liver Resection in Brazil: A National Survey

Laparoscopic and Robot-Assisted Hepatic Surgery: An Historical Review

Surgical Therapy of Hepatocellular Carcinoma: State of the Art Liver Resection

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