Laparoscopic hepatic wedge resection of hemangioma: report of two cases

Bengisun, Uĝur; Özbaş, Serdar; Gürel, Mehmet Salih; Ensarı, Arzu

doi:10.1007/s004230000146

Cited by 15 publications

(17 citation statements)

References 14 publications

(18 reference statements)

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“…Thus, multicenter clinical trials are desirable to confirm these promising results. In view of the results of this and other studies [1][2][3][4], we suppose that laparoscopic hepatectomy will become a popular technique for the treatment of benign and malignant liver lesions.…”

Section: Discussionmentioning

confidence: 99%

“…In 1991, Reich et al [7] firstly reported on laparoscopic hepatectomy, thereby arousing the interest of many surgeons in this field. Since then laparoscopic hepatic resection techniques have been developed and special devices have been supplied, and laparoscopic hepatectomy has been becoming a more common procedure for the treatment of benign and malignant liver lesions [1][2][3][4]. The most important technique in laparoscopic hepatectomy is liver parenchymal transection.…”

Section: Discussionmentioning

confidence: 99%

“…This is mainly due to the fact that the liver is a giant solid organ with high blood supply and a blood circulation which is difficult to control, resulting in complicated transection homeostasis management. Despite advances in laparoscopic instrumentation in the recent years, laparoscopic liver surgery thus has remained a severe intervention [1][2][3][4]. The complexity of the laparoscopic techniques and undefined inclusion criteria are additional factors, limiting the use of laparoscopic techniques in hepatectomy.…”

Section: Introductionmentioning

confidence: 99%

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A Laparoscopic Multifunctional Operative Device in Laparoscopic Hepatectomy

Ji¹,

Peng²,

Cai³

2004

Visc Med

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Background: This study aims to investigate the feasibility of a laparoscopic multifunctional operative device (LMOD) in laparoscopic hepatectomy in both pigs and patients. Patients and Methods: A new laparoscopic operative device was specially designed and applied for laparoscopic liver resection in 6 pigs and 25 human patients. Of these patients 11 were men and 14 women. Their mean age was 43.3 years (range 35 to 56 years). Ten patients were diagnosed to have primary hepatocellular carcinoma, with 6 of whom suffering from mild liver cirrhosis, and the other 14 had hepatic hemangioma. Time of operation, time of liver transection, blood loss, weight of resected specimen and operative complications were measured. Venous blood was drawn for liver function tests before and after the operation. Both gross and microscope examinations were performed in animals 4 weeks after the operation. Results: All operations were performed successfully. However, 2 pigs died from anesthesia complication after the operation. The other animals recovered uneventful. In animal studies, the mean time of liver transection was 4 min and the biggest specimen 5 × 4 × 2 cm. Histological investigations performed on liver specimens taken from the surface of the liver remnant showed that fibrosis and necrosis were significantly enhanced in animals in which hepatectomy was done. In the human patients, the mean operating time was 100 min. Blood loss was 460 ml on average, and the size of the resected specimen ranged between 4 × 3 × 2 and 10 × 9 × 7 cm. Operative complications did not occur. Liver enzyme values were elevated after the operation in both animals and patients, but turned to normal within 1 week after the operation, at least in human patients. Conclusion: The LMOD can be used very effectively in laparoscopic hepatectomy by allowing a considerable number of manipulations such as dissection, coagulation, curettage, irrigation, and aspiration. The use of this instrument can help to keep clear the operative field, to decrease the blood loss and to shorten the operating time. Its use in minimal invasive hepatobiliary surgery is promising.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A Laparoscopic Multifunctional Operative Device in Laparoscopic Hepatectomy

Ji¹,

Peng²,

Cai³

2004

Visc Med

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“…Whether the dierences in the stress and immune response lead to dierent outcomes in oncological surgery, especially regarding long-term survival, is still under discussion. Laparoscopic liver resections have been performed in only a few hospitals since 1995, and some articles have been published on this topic [2,6,23,25]. Prospective data on the advantages of laparoscopic liver resection have not been published.…”

Section: Introductionmentioning

confidence: 95%

Comparison of laparoscopic versus conventional technique in colonic and liver resection in a tumor-bearing small animal model

et al. 2002

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These results suggest that the type of intraabdominal operation (colon or liver) may influence the degree of trauma of an operation more than the type of technique (laparoscopic or open). The perioperative alteration of stress and immune function has no implications on the long-term results, such as survival time or recurrence, neither in the curative nor in the palliative setting. The thesis that laparoscopic surgery results in less pain, which in turn means less stress and less alteration of the immune system and therefore results in a lower rate of postoperative metastasis is only valid for laparoscopic colonic resection in our model. The part of the thesis that states that fewer metastases should occur after laparoscopic oncological surgery cannot be confirmed in our study.

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“…Successful laparoscopic liver biopsy procedures have been reported for a number of small series, mainly with the use of laparoscopic coagulating shears (Harmonic scalpel TM , Ethicon Endo-Surgery, CVG, Cincinnati, Ohio) or a vascular liner stapler [1,11]. However, successful larger laparoscopic hepatic resections have recently been reported in adults [5,7,11].…”

Section: Introductionmentioning

confidence: 98%

Laparoscopic liver biopsy using cup-shaped punch biopsy forceps and argon beam coagulator in children

et al. 2007

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Needle liver biopsy is insufficient for measuring enzyme activity in liver tissue in child cases of intrahepatic cholestasis because the biopsy specimen obtained is too small. This study was undertaken to validate the feasibility of a new, relatively non-invasive laparoscopic liver biopsy technique combining the use of laparoscopic cup-shaped punch biopsy forceps (CPBF) and an argon beam coagulator (ABC) handpiece for the diagnosis and examination of liver enzyme activity in cases of intrahepatic cholestasis in children. The authors performed laparoscopic liver biopsy with the combined use of laparoscopic CPBF and an ABC handpiece in 10 children aged 4 months to 9 years old. Two 5-mm trocars were inserted in each patient after their abdomens had been filled with carbon dioxide gas at a pressure of 8 mmHg. Four to five specimens (each: 0.5 cm(3) in size) were taken at the anterior edge of the left lobe of the liver using laparoscopic CPBF. ABC was sprayed on to the cut liver surface to achieve hemostasis. The duration of the laparoscopic procedure ranged from 25 to 64 (44 +/- 12.8) min. The maximum intraoperative hemorrhage from the biopsied liver bed was 30 ml. The bleeding was easily controlled using ABC for about 1 min. There were no cases of postoperative bleeding, bile leakage from the cut surface, nor intraabdominal infection. There were also no death cases, and only one complication (hydrocele testis) was recorded. Examination by microscopy and assays of enzyme activities were performed using these biopsy specimens, which were sufficient for diagnosis in all patients. Laparoscopic liver biopsy combining the use of laparoscopic CPBF and an ABC handpiece can be performed safely, is less invasive, and provides sufficient samples for examination both by microscopy and enzyme activity assays.

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Laparoscopic hepatic wedge resection of hemangioma: report of two cases

Cited by 15 publications

References 14 publications

A Laparoscopic Multifunctional Operative Device in Laparoscopic Hepatectomy

A Laparoscopic Multifunctional Operative Device in Laparoscopic Hepatectomy

Comparison of laparoscopic versus conventional technique in colonic and liver resection in a tumor-bearing small animal model

Laparoscopic liver biopsy using cup-shaped punch biopsy forceps and argon beam coagulator in children

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