Ultrasound-guided anatomical liver resection using a compression technique combined with indocyanine green fluorescence imaging

Procopio, Fabio; Torzilli, Guido; Franchi, Eloisa; Cimino, Matteo; Viganò, Luca; Donadon, Matteo; Fabbro, Daniele Del

doi:10.1016/j.hpb.2020.05.009

Cited by 11 publications

(8 citation statements)

References 22 publications

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“…One of the most important findings of the present review is that a number of authors have shown their experiences to use different agents depending on their preferences under Glissonean pedicle clamping/occlusion or direct portal vein injection to determine the demarcation line in ALR. By means of Glissonean pedicle clamping/occlusion, intersegmental/sectional planes are visualized not only on the liver surfaces but also on the raw surfaces during liver transection using the fluorescence images after systematic injection of ICG (ICG negative staining) 53,75,80,82,85,90,95‐97,99,101‐103 . Direct injection of ICG into the portal branches responsible for resected territories or surrounding territories is also capable to see the clear demarcation line (ICG positive 82,84‐95,98,99,102 or counter staining 81,97 ).…”

Section: Discussionmentioning

confidence: 99%

“…In 11 articles, 18,59,67,70,77-83 the importance of using IOUS was highlighted and its evolution through the years was described, despite its application during MILS requiring further skills as compared to open surgery. In addition, the various intraoperative use of the indocyanine green (ICG) was assessed in 24 articles, 53,75,[80][81][82][84][85][86][87][88][89][90][91][92][93][94][95][96][97][98][99][100][101][102][103] the portal dye injection in eight articles, 18,70,79,83,94,98,104,105 and contrast-enhanced ultrasonography in three articles, 79,80,82 when performing ALR.…”

Section: Liver Surface or Intrahepatic Anatomic Structuresmentioning

confidence: 99%

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Landmarks to identify segmental borders of the liver: A review prepared for PAM‐HBP expert consensus meeting 2021

Wakabayashi

Cacciaguerra

Ciria

et al. 2021

J Hepato Biliary Pancreat

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Background:In preparation for the upcoming consensus meeting in Tokyo in 2021, this systematic review aimed to analyze the current available evidence regarding surgical anatomy of the liver, focusing on useful landmarks, strategies and technical tools to perform precise anatomic liver resection (ALR). Methods: A systematic review was conducted on MEDLINE/PubMed for English articles and on Ichushi database for Japanese articles until September 2020. The quality assessment of the articles was performed in accordance with the Scottish Intercollegiate Guidelines Network (SIGN). Results: A total of 3169 manuscripts were obtained, 1993 in English and 1176 in Japanese literature. Subsequently, 63 English and 20 Japanese articles were selected and reviewed. The quality assessment of comparative series and case series was revealed to be usually low; only six articles were qualified as high quality. Forty-two articles focused on analyzing intersegmental/sectional planes and their relationship

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Section: Discussionmentioning

confidence: 99%

Section: Liver Surface or Intrahepatic Anatomic Structuresmentioning

confidence: 99%

Landmarks to identify segmental borders of the liver: A review prepared for PAM‐HBP expert consensus meeting 2021

Wakabayashi

Cacciaguerra

Ciria

et al. 2021

J Hepato Biliary Pancreat

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“…The hooking technique is performed: the traction applied to the tape causes a distortion of the encircled pedicle (white arrows) allowing to identify the vessel and the level of section (D). The resection is completed with an adequate surgical margin (E) (colour figure online) technique, and Takasaki approach [10,11]. The latter requires a deep intraparenchymal dissection of the Glissonean pedicles and a careful identification of the vessels to section.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic application of the hooking technique for ultrasound-guided minimally invasive liver surgery

et al. 2021

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Laparoscopic liver surgery has a wide diffusion worldwide, but the reproducibility of a parenchyma-sparing approach with a minimally invasive technique is still to explore. Intraoperative ultrasound (IOUS) is a mandatory tool to guarantee safety (transection plane) and oncological adequacy (margin) of minor but complex resections for deep-located tumors. The hooking technique has been developed exactly with this aim: once a vessel is isolated and encircled, the surgeon applies gentle traction on the tape surrounding the vessel and, under IOUS vision, "recognizes" the vessel and the adequate level of section. At present, advanced IOUS-guided maneuvers have limited application to laparoscopic liver surgery. We report the first application of the hooking maneuver during laparoscopic hepatectomy in three consecutive patients. In all cases, it was successfully performed and allowed to section the proper vessel at the right level. No procedure-related complications occurred and no ischemic areas of the remnant liver were evident. All resections had a negative surgical margin. Even if technically demanding, the laparoscopic hooking technique is a further step toward the standardization of a minimally invasive approach to advanced parenchyma-sparing liver surgery.

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“…When performing Glissonean pedicle clamping or occlusion, IPs are visualized not only on the liver surfaces but also on the deep raw surfaces during the liver transection using the fluorescence images after systemic injection of ICG (ICG negative staining). [45][46][47][48][49][50][51][52][53] The negative staining technique for identifying the area of the responsible Glissonean pedicle is found to be simpler and more feasible than the direct ICG injection into a portal vein branch, particularly in the setting of MIALR, as the latter requires the surgeon to be accustomed to IOUS and careful manipulation of the needle. 48 Prior to ICG staining, segmentectomies were more performed in an intentional way using external landmarks (gallbladder, roots of HV, round/falciform ligament), intraoperative ultrasound, IVs guidance and selective inflow clamping with or without dye (methylene blue injection).…”

Section: A Liʃle 24%mentioning

confidence: 99%

Expert Consensus Guidelines: How to safely perform minimally invasive anatomic liver resection

Gotohda

Cherqui

Geller

et al. 2021

J Hepato Biliary Pancreat

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Background The concept of minimally invasive anatomic liver resection (MIALR) is gaining popularity. However, specific technical skills need to be acquired to safely perform MIALR. The “Expert Consensus Meeting: Precision Anatomy for Minimally Invasive HBP Surgery (PAM‐HBP Surgery Consensus)” was developed as a special program during the 32nd meeting of the Japanese Society of Hepato‐Biliary‐Pancreatic Surgery (JSHBPS). Methods Thirty‐four international experts gathered online for the consensus. A Research Committee performed a comprehensive literature review, classifying studies according to the Scottish Intercollegiate Guidelines Network method. Based on the literature review and experts’ opinions, tentative recommendations were drafted and circulated among experts using online Delphi Rounds. Finally, formulated recommendations were presented online in the Expert Consensus Meeting of the JSHBPS on February 23rd, 2021. The final recommendations were validated and finalized by the 2nd Delphi Round in May 2021. Results Seven clinical questions were selected, and 22 recommendations were formulated. All recommendations reached more than 85% consensus among experts at the final Delphi Round. Conclusions The Expert Consensus Meeting for safely performing MIALR has presented a set of clinical guidelines based on available literature and experts’ opinions. We expect these guidelines to have a favorable effect on the safe implementation and development of MIALR.

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Ultrasound-guided anatomical liver resection using a compression technique combined with indocyanine green fluorescence imaging

Cited by 11 publications

References 22 publications

Landmarks to identify segmental borders of the liver: A review prepared for PAM‐HBP expert consensus meeting 2021

Landmarks to identify segmental borders of the liver: A review prepared for PAM‐HBP expert consensus meeting 2021

Laparoscopic application of the hooking technique for ultrasound-guided minimally invasive liver surgery

Expert Consensus Guidelines: How to safely perform minimally invasive anatomic liver resection

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