J Korean Med Sci.  2006 Feb;21(1):69-74. 10.3346/jkms.2006.21.1.69.

Initial Experiences with Laparoscopy-assisted and Total Laparoscopy for Anatomical Liver Resection: A Preliminary Study

• Min SK
• Han HS
• Kim SW
• Park YH
• Lee HK
• Lee JH

• KMID: 2157785
• DOI: http://doi.org/10.3346/jkms.2006.21.1.69

Abstract

Although laparoscopic surgery has become more popular, its technical difficulties have limited the applications of this technique to liver surgery. We report here on our experience with liver resection with using the laparoscopy-assisted (Lap-Assist) and total laparoscopic (Total-Lap) methods. From April 2001 to June 2003, a total of 20 laparoscopic anatomical resections of the liver were retrospectively reviewed. These were comprised of 10 cases in which the Lap-Assist method was used (these were performed during the early study period), and 10 cases in which the Total-Lap was used (these were done in the later study period). In the Lap-Assist group, the following resections were performed: 7 cases of left lateral sectionectomy, a case of left hemihepatectomy, a case of right hemihepatectomy and a case of open conversion. In the Total-Lap group, 6 cases of left hemihepatectomy and 4 cases of left lateral sectionectomy were performed. The sizes of the incisions were 8.7 cm and 4.6 cm, respectively, (p=0.000). There were no differences in the operation times, the transfusion amounts, the starting days of the patients' diets, the complication rates or the durations of the hospital stay between the two groups. Both the laparoscopy-assisted method and the total laparoscopic method are feasible to use for performing anatomical liver resection.

Keyword

Laparoscopy; Liver; Liver Resection

MeSH Terms

Adult
Aged
Carcinoma, Hepatocellular/surgery
Cholelithiasis/surgery
Comparative Study
Female
Follow-Up Studies
Hepatectomy/*methods
Humans
Laparoscopy/*methods
Length of Stay
Liver/pathology/*surgery
Liver Neoplasms/surgery
Male
Middle Aged
Treatment Outcome

Figure

• 

  Fig. 1 The diagram for the position and extensional incision of the ports that were used for the laparoscopy-assisted method. (A) The initial position of the trocars before the parenchymal dissection. (B) The extensional incision between the two ports that were used for parenchymal dissection.

• 

  Fig. 2 Diagram for the position of the trocars that were for total laparoscopic hepatectomy.

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