Laparoscopic left hepatectomy in swine: a safe and feasible technique

Abstract

A purely laparoscopic four-port approach was created for left hepatectomy in pigs. A polyethylene loop was placed on the left two hepatic lobes for traction and lift. Next, penetrating ligation of the lobes using of a double row of silk sutures was performed to control bleeding. A direct hepatic transection was completed using a monopolar hook electrode without meticulous dissection of the left hepatic vein. The raw surface of the liver was coagulated and sealed with fibrin glue. Lobes were retrieved through an enlarged portal. Laparoscopic hepatic lobectomy was completed in all pigs without the use of specialized instruments and with a mean operative time of 179 ± 9 min. No significant perioperative complications were observed. The average weight of each resected lobe was 180 ± 51 g. Complete blood count as well as serum organics and enzyme levels normalized after about 2 weeks. During necropsy, adhesion of the hepatic raw surface to the gastric wall and omentum were observed. No other abnormalities were identified. This minimally invasive left hepatectomy technique in swine could serve as a useful model for investigating liver diseases and regeneration, and offer preclinical information to improve hepatobiliary surgical procedures.

Adipose-derived stem cells alleviate liver apoptosis induced by ischemia-reperfusion and laparoscopic hepatectomy in swine

“…In the Sham group, only the pneumoperitoneum was established and the liver lobe was flipped. Both the IRI group and the ADSCs group underwent left hemihepatectomy as previously described after right hepatic ischemia for 60 min 21 . The ADSCs group received one ADSC injection (1 × 10 6 /kg) through the liver parenchyma immediately after hemihepatectomy.…”

Adipose-Derived Stem Cells Protect Ischemia-Reperfusion and Partial Hepatectomy by Attenuating Endoplasmic Reticulum Stress

“…CO 2 was injected into the abdominal cavity via a veress needle, and the pneumoperitoneum pressure was maintained at 10 mm Hg. Left hepatectomy and right hepatic ischemia for 60 min was performed in the IRI and ADSCs groups by laparoscopy as described previously (Zhang et al, 2014), while the liver lobe was only flipped in the Sham group. The animals in the ADSCs group were injected ADSCs through the liver parenchyma by laparoscopic instruments immediately after hemi-hepatectomy (10 6 cells/kg).…”

Secretome of Adipose-Derived Stem Cells Protect Ischemia-Reperfusion and Partial Hepatectomy by Attenuating Autophagy

“…Establishment of a miniature pig model of hepatic I/R combined with hepatectomy [25],The miniature pigs were kept on the operating table in a supine position, and the temperature of the operating table was adjusted to maintain at 37℃. Respiratory anesthesia was used for intraoperative anesthesia, and then laparoscopic minimally invasive technique was used for model construction, right hemi-hepatic ischemia for 60 min, and left hemi-hepatectomy.…”