Minimally invasive surgery and liver transplantation: is it a safe, feasible, and effective approach?

López-López, Víctor; Martínez-Serrano, María Ángeles; Ruiz-Manzanera, Juan José; Eshmuminov, Dilmurodjon; Ramírez, Pablo

doi:10.1007/s13304-023-01506-7

Cited by 3 publications

(4 citation statements)

References 45 publications

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“…Notably, our patients’ recovery times were longer than those described for minimally invasive surgery. 28 …”

Section: Discussionmentioning

confidence: 99%

“…Notably, our patients' recovery times were longer than those described for minimally invasive surgery. 28 Our technique could be used in the context of complex incisional hernias derived from renal transplants, where complication and recurrence rates are higher because of risk factors such as an increased need of immunosuppression, more complex incisions, and a higher rate of diabetes and cardiovascular diseases in this patient population. 29,30 We did not encounter hyperacute, acute, or chronic rejection in our study, and there was no need to adjust the immunosuppression regimens, even in patients receiving monotherapy with mycophenolate, which is a minimally tolerable immunosuppressant.…”

Section: Discussionmentioning

confidence: 99%

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Hernia Correction After Liver Transplantation Using Nonvascularized Fascia

Justo,

Caso,

Marcacuzco

et al. 2024

Transplantation Direct

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Background. Liver transplantation is an increasingly frequent surgical procedure, with elevated rates of postoperative incisional hernias ranging from 5% to 46%. There are numerous known risk factors for incisional hernia, including the type of incision, patient sex, and presence of comorbidities such as diabetes, ascites, older age, and the use of steroids. Most studies on the treatment of incisional hernias in patients who have undergone liver transplantation have shown consistently high rates of complications. Consequently, we propose the use of nonvascular fascia for the symptomatic treatment of incisional hernias in patients with concomitant liver transplantation. Methods. We performed our new technique on 8 patients, who had previously undergone liver transplantation, between January 2019 and January 2023. The patients were examined using imaging techniques during the follow-up period. Results. Of the 8 patients, 7 were liver transplant recipients and 1 was a combined liver-kidney transplant patient. The median donor age was 57 y (5–66 y), whereas the mean recipient age was 58 y (31–66 y). The median patient height and weight were 163 cm (117–185 cm) and 76 kg (17–104 kg), respectively. Immunosuppression did not change in fascia recipients. The median time between transplantation and hernia repair surgery was 41 mo (5–116 mo). The sizes of the aponeurotic defects varied from 6 × 6 to 25 × 20 cm. Two patients experienced complications: one experienced bulging that required reintervention and the other experienced surgical site seroma. There was no mortality related to the use of the technique, and none were reported during follow-up. Conclusions. With its promising results, nonvascularized fascial transplantation can be a successful treatment for incisional hernias in patients who had previously received a liver transplant.

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“…Notably, our patients’ recovery times were longer than those described for minimally invasive surgery. 28 …”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Hernia Correction After Liver Transplantation Using Nonvascularized Fascia

Justo,

Caso,

Marcacuzco

et al. 2024

Transplantation Direct

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“…Nowadays, the efficacy and safety of MIS, even on patients with the above contraindications, has been scientifically proven [5]. The above findings have led to the application of MIS in liver transplant recipients as well as living liver donors, with potentially better outcomes than the traditional open techniques [6,7].…”

Section: Introductionmentioning

confidence: 99%

“…In the past, application of MIS techniques has been a matter of debate due to the fear of graft loss. During recent years, MIS application reports in LT recipients have increased, with the majority of them relating to the treatment of postoperative applications [7].…”

Section: Introductionmentioning

confidence: 99%

Minimally Invasive Surgery in Liver Transplantation: From Living Liver Donation to Graft Implantation

Avramidou,

Terlemes,

Lymperopoulou

et al. 2024

Livers

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Since the end of the 20th century and the establishment of minimally invasive techniques, they have become the preferred operative method by many surgeons. These techniques were applied to liver surgery for the first time in 1991, while as far as transplantation is concerned their application was limited to the living donor procedure. We performed a review of the literature by searching in Pubmed and Scopus using the following keywords: Liver transplantation, Minimally invasive surgery(MIS) living liver donor surgery. Applications of MIS are recorded in surgeries involving the donor and the recipient. Regarding the recipient surgeries, the reports are limited to 25 patients, including combinations of laparoscopic, robotic and open techniques, while in the living donor surgery, the reports are much more numerous and with larger series of patients. Shorter hospitalization times and less blood loss are recorded, especially in centers with experience in a large number of cases. Regarding the living donor surgery, MIS follows the same principles as a conventional hepatectomy and is already the method of choice in many specialized centers. Regarding the recipient surgery, significant questions arise mainly concerning the safe handling of the liver graft.

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Quantitative ultrasound (QUS) in the evaluation of liver steatosis: data reliability in different respiratory phases and body positions

Rocca,

Komici,

Brunese

et al. 2024

Radiol med

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Liver steatosis is the most common chronic liver disease and affects 10–24% of the general population. As the grade of disease can range from fat infiltration to steatohepatitis and cirrhosis, an early diagnosis is needed to set the most appropriate therapy. Innovative noninvasive radiological techniques have been developed through MRI and US. MRI-PDFF is the reference standard, but it is not so widely diffused due to its cost. For this reason, ultrasound tools have been validated to study liver parenchyma. The qualitative assessment of the brightness of liver parenchyma has now been supported by quantitative values of attenuation and scattering to make the analysis objective and reproducible. We aim to demonstrate the reliability of quantitative ultrasound in assessing liver fat and to confirm the inter-operator reliability in different respiratory phases. We enrolled 45 patients examined during normal breathing at rest, peak inspiration, peak expiration, and semi-sitting position. The highest inter-operator agreement in both attenuation and scattering parameters was achieved at peak inspiration and peak expiration, followed by semi-sitting position. In conclusion, this technology also allows to monitor uncompliant patients, as it grants high reliability and reproducibility in different body position and respiratory phases.

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Minimally invasive surgery and liver transplantation: is it a safe, feasible, and effective approach?

Cited by 3 publications

References 45 publications

Hernia Correction After Liver Transplantation Using Nonvascularized Fascia

Hernia Correction After Liver Transplantation Using Nonvascularized Fascia

Minimally Invasive Surgery in Liver Transplantation: From Living Liver Donation to Graft Implantation

Quantitative ultrasound (QUS) in the evaluation of liver steatosis: data reliability in different respiratory phases and body positions

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