Application of a Z-Shaped Umbilical Incision and a Saline-Cooled Radiofrequency Device to Single-Incision Laparoscopic Surgery for a Huge Liver Cyst: Report of a Case

Igami, Tsuyoshi; Tsuchiya, Tomonori; Yokoyama, Yukihiro; Sugawara, Gen; Mizuno, Takashi; Nagino, Masato

doi:10.9738/intsurg-d-14-00198.1

Cited by 5 publications

(4 citation statements)

References 17 publications

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“…To our knowledge, this is the first successful case of a “pure” SILS for treatment of an unruptured aneurysm of the splenic artery. We utilized a Z-shaped umbilical incision and a gel port to obtain a wide entrance into the abdominal cavity [6]; therefore, we obtained easy and excellent manipulability despite SILS. Consequently, SILS for an unruptured aneurysm of the splenic artery was achieved with a successful outcome.…”

Section: Discussionmentioning

confidence: 99%

“…Then, a Z-shaped skin incision was made in the umbilical region and a gel port (GelPOINT Advanced Access Platforms®; Applied Medical Resources Corp., Rancho Santa Margarita, CA, USA) was placed through the umbilical incision with a 12-mm Hg pneumoperitoneum using carbon dioxide (Fig. 2) [6]. A 12-mm and two 10-mm ports were placed through the gel port (Fig.…”

Section: Case Reportmentioning

confidence: 99%

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Single-Incision Laparoscopic Splenectomy for an Unruptured Aneurysm of the Splenic Artery

Toyoda¹,

Igami²,

Ochiai³

et al. 2017

Med Princ Pract

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Objective: We describe our experience of single-incision laparoscopic splenectomy (SILS) for an unruptured aneurysm of the splenic artery. Clinical Presentation and Intervention: A 73-year-old woman was diagnosed as having a splenic aneurysm which grew from 14 to 22 mm in diameter within 2 years. Due to a contrast agent allergy, transcatheter arterial embolization could not be performed; therefore, SILS was performed with a 4-cm Z-shaped incision. The operative time and intraoperative blood loss were 132 min and 27 mL, respectively. The patient was discharged 4 days after surgery. Conclusion: In selected cases, SILS is a suitable and safe procedure for an unruptured aneurysm of the splenic artery.

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Section: Discussionmentioning

confidence: 99%

Section: Case Reportmentioning

confidence: 99%

Single-Incision Laparoscopic Splenectomy for an Unruptured Aneurysm of the Splenic Artery

Toyoda¹,

Igami²,

Ochiai³

et al. 2017

Med Princ Pract

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“…For the surgical procedure, the patient was placed in the reverse Trendelenburg position. A Z‐shaped incision was made at the umbilical region (Figure ) , a 12‐mm port was placed through the umbilical incision, and a 12‐mmHg pneumoperitoneum was created with CO 2 . Because severe adhesions in the right side of the abdominal cavity were revealed by laparoscopy (Figure ), ports could not be placed through the right side of the abdominal wall.…”

Section: Case Presentationmentioning

confidence: 99%

“…Thick branches of the Glissonian pedicle and hepatic vein were divided with clips. After the division of the hepatic parenchyma, the resected specimen was placed into a retrieval bag and removed through the Z‐shaped incision at the umbilical region . After irrigation of the abdominal cavity, a drainage tube was placed near the cut surface of the liver through the cranial side of the 5‐mm port incision.…”

Section: Case Presentationmentioning

confidence: 99%

Laparoscopic repeat hepatectomy after right hepatopancreaticoduodenectomy

Igami

Komaya

Hirose

et al. 2016

Asian J Endoscop Surgery

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Although laparoscopic hepatectomy is widely accepted for primary hepatectomy, the clinical value of laparoscopic hepatectomy for repeat hepatectomy is still challenging. We herein describe our experience with laparoscopic repeat hepatectomy after right hepatopancreaticoduodenectomy. A 72-year-old woman who had undergone right hepatopancreaticoduodenectomy for perihilar cholangiocarcinoma 31 months prior was diagnosed with liver metastasis in segment 3. We performed laparoscopic repeat hepatectomy. Because mild adhesions in the left side of the abdominal cavity were detected by laparoscopy, the planned procedure was accomplished. The operative time and intraoperative blood loss were 139 min and less than 1 mL, respectively. The patient was discharged at 6 days after surgery and was healthy with no evidence of recurrence at 21 months after laparoscopic repeat hepatectomy. Laparoscopic repeat hepatectomy is a suitable and safe procedure for minor hepatectomy, provided that careful technique is used after the working space is secured under pneumoperitoneum.

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Laparoscopic deroofing of simple liver cysts: do ancillary techniques, surgical devices, and indocyanine green improve outcomes?

et al. 2023

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Summary Background Giant liver cysts causing compression symptoms require surgical therapy. Laparoscopy is nowadays considered the first-line approach and has been shown to be non-inferior to open surgery. Ancillary techniques and novel technologies may have the potential to reduce complications rates and improve long-term outcomes. Methods The management of a female patient with a giant and symptomatic liver cyst is reported, as is a literature search in PubMed and Scopus spanning the past two decades, with the aim of assessing current evidence regarding procedural details of laparoscopic deroofing. Results Wide laparoscopic deroofing of a 21-cm liver cyst arising from segment 6 was safely performed under indocyanine green fluorescence imaging using a combination of ultrasonic energy excision and stapling. A contemporary literature review showed that only 22 of the 35 publications included details of the surgical procedure. Ancillary techniques such as omentopexy, argon plasma coagulation, monopolar radiofrequency device ablation, and ethanol sclerotherapy were rarely used (10.8% of patients). Use of energy devices and/or linear staplers was reported in 22 (62.8%) studies. Indocyanine green fluorescence was reported in 4 (11.4%) studies. Conclusion The case report and the literature review show that wide laparoscopic deroofing of giant liver cysts is an effective and relatively simple procedure. Use of emerging technology such as indocyanine green fluorescence imaging can further enhance precision surgery and minimize complications and long-term recurrence rates.

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Application of a Z-Shaped Umbilical Incision and a Saline-Cooled Radiofrequency Device to Single-Incision Laparoscopic Surgery for a Huge Liver Cyst: Report of a Case

Cited by 5 publications

References 17 publications

Single-Incision Laparoscopic Splenectomy for an Unruptured Aneurysm of the Splenic Artery

Single-Incision Laparoscopic Splenectomy for an Unruptured Aneurysm of the Splenic Artery

Laparoscopic repeat hepatectomy after right hepatopancreaticoduodenectomy

Laparoscopic deroofing of simple liver cysts: do ancillary techniques, surgical devices, and indocyanine green improve outcomes?

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