Laparoendoscopic single site (LESS) surgery for left-lateral hepatic sectionectomy as an alternative to traditional laparoscopy: case-matched analysis from a single center

Aldrighetti, Luca; Ratti, Francesca; Catena, Marco; Pulitanò, Carlo; Ferla, Fabio; Cipriani, Federica; Ferla, Gianfranco

doi:10.1007/s00464-012-2147-1

Cited by 33 publications

(44 citation statements)

References 25 publications

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“…[17] and Aldrighetti et al . [21] have reported on the use of SILS in left lateral lobectomies. In both their publications the blood loss was greater than in our case series.…”

Section: Discussionmentioning

confidence: 99%

Single incision laparoscopic hepatectomy: Advances in laparoscopic liver surgery

et al. 2014

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BACKGROUND:Laparoscopic liver surgery is now an established practice in many institutions. It is a safe and feasible approach in experienced hands. Single incision laparoscopic surgery (SILS) has been performed for cholecystectomies, nephrectomies, splenectomies and obesity surgery. However, the use of SILS in liver surgery has been rarely reported. We report our initial experience in seven patients on single incision laparoscopic hepatectomy (SILH).PATIENTS AND METHODS:From October 2010 to September 2012, seven patients underwent single-incision laparoscopic liver surgery. The abdomen was approached through a 25 mm periumbilical incision. No supplemental ports were required. The liver was transected using a combination of LigaSure™ (Covidien-Valleylab. Boulder. USA), Harmonic Scalpel and Ligaclips (Ethicon Endo-Surgery, Inc.).RESULTS:Liver resection was successfully completed for the seven patients. The procedures consisted of two partial resections of segment three, two partial resections of segment five and three partial resections of segment six. The mean operative time was 98.3 min (range: 60-150 min) and the mean estimated blood loss was 57 ml (range: 25-150 ml). The postoperative courses were uneventful and the mean hospital stay was 5.1 days (range: 1-13 days). Pathology identified three benign and four malignant liver tumours with clear margins.CONCLUSION:SILH is a technically feasible and safe approach for wedge resections of the liver without oncological compromise and with favourable cosmetic results. This surgical technique requires relatively advanced laparoscopic skills. Further studies are needed to determine the potential advantages of this technique, apart from the better cosmetic result, compared to the conventional laparoscopic approach.

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“…[17] and Aldrighetti et al . [21] have reported on the use of SILS in left lateral lobectomies. In both their publications the blood loss was greater than in our case series.…”

Section: Discussionmentioning

confidence: 99%

Single incision laparoscopic hepatectomy: Advances in laparoscopic liver surgery

et al. 2014

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“…Since then, most reports on SILLR have been single case reports or case series. Several have described the safety and feasibility of SILLR , and there have been only a few cohort studies on conventional laparoscopic surgery and SILLR. Aldrighetti et al .…”

Section: Perspective On Reduced Port Surgery In Laparoscopic Liver Rementioning

confidence: 99%

Advances in reduced port laparoscopic liver resection

Ban

Kudo

Irie

et al. 2014

Asian J Endoscop Surgery

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Reduced port surgery has been attracting attention in the field of minimally invasive surgery. Although the use of SILS is becoming widespread, technical difficulty has delayed its adoption for laparoscopic liver resection. Recently, advances in laparoscopic liver resection have been made in tandem with advances in surgical skill and devices. The main driver in conventional laparoscopic liver resection's evolution to become less surgically invasive seems to be single-incision laparoscopic liver resection (SILLR). To date, most reports on SILLR have been single case reports or case series. Only a few cohort studies on conventional laparoscopic surgery and SILLR have been conducted. Recent reports have described the use of SILLR for well-localized lesions and solitary tumors located in the anterolateral segments of the liver or left liver lobe, but its application remains limited to partial resection and left lateral sectionectomy. The feasibility and safety of SILLR have been demonstrated, but additional work is needed for standardization of the procedure.

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“…Las primeras publicaciones corresponden a lesiones benignas, ampliá ndose posteriormente al tratamiento de enfermedad maligna como metá stasis y hepatocarcinomas, con resultados similares a los de la laparoscopia convencional [21][22][23][24] .…”

Section: Discusió Nunclassified

“…El tiempo quirú rgico medio fue de 153 min, similar al descrito en otras publicaciones [18][19][20][21] . El tiempo invertido en la hepatectomía izquierda alarga el tiempo medio empleado en nuestros casos, siendo de 138 min para la seccionectomía lateral izquierda.…”

Section: Discusió Nunclassified

“…La cirugía laparoscó pica por incisió n ú nica se aplicó inicialmente a procedimientos como la colecistectomía 12 y la apendicectomía 13 y posteriormente se ha ido ampliando a otros campos como la cirugía bariá trica, la cirugía de colon o la esplenectomía [14][15][16] . La aplicació n en cirugía hepá tica se reduce hoy en día a publicaciones de series de casos clínicos [17][18][19][20][21] .…”

Section: Introducció Nunclassified

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Abordaje laparoscópico por incisión única del hígado izquierdo: experiencia inicial

et al. 2014

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Laparoendoscopic single site (LESS) surgery for left-lateral hepatic sectionectomy as an alternative to traditional laparoscopy: case-matched analysis from a single center

Abstract: For left-lateral hepatic sectionectomy, LESS surgery is technically feasible and as safe as traditional laparoscopic surgery in terms of intraoperative and postoperative results, even though requiring both hepatobiliary and laparoscopic technique experience.

Cited by 33 publications

References 25 publications

Single incision laparoscopic hepatectomy: Advances in laparoscopic liver surgery

Single incision laparoscopic hepatectomy: Advances in laparoscopic liver surgery

Advances in reduced port laparoscopic liver resection

Abordaje laparoscópico por incisión única del hígado izquierdo: experiencia inicial

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