Laparoscopy-assisted hepatic lobectomy using hilar Glissonean pedicle transection

Abstract

Although many reports have described laparoscopic minor liver resections, major hepatic resection, including right or left lobectomy, has not been widely developed because of technical difficulties. This article describes a new technique for performing laparoscopy-assisted right or left hepatic lobectomy using hilar Glissonean pedicle transection. Laparoscopic mobilization of the right or left hepatic lobe is performed, including dissection of the round, faliciform, triangular, and coronary ligaments. The right or left Glissonean pedicle is encircled and divided laparoscopically. A parenchymal dissection is then performed though the upper median or right subcostal incision, through which the resected liver is removed. We successfully performed this procedure in 6 patients without blood transfusion or serious complications. Laparoscopy-assisted hepatic lobectomy using hilar Glissonean pedicle transection can be feasible and safe in highly selected patients.

Caudal approach to pure laparoscopic posterior sectionectomy under the laparoscopy-specific view

“…Online Submissions: http://www.wjgnet.com/esps/ wjgs@wjgnet.com doi:10.4240/wjgs.v5.i6.173 being used, laparoscopic hepatectomy mainly applied to local resections in antero-lateral segments of the liver [1][2][3] ; major hepatectomies were often performed using handassisted [4][5][6] or hybrid [7][8][9][10] procedures. However, there are increasing reports for anatomical resections with intrahepatic [11][12][13][14] and extrahepatic [15] Glissonian approach and also of the right side liver [16][17][18][19] .…”

Hilar Glissonean Access in Laparoscopic Liver Resection

“…In the same way, the metallic arch of Endo Mini-Retract is meticulously extended between the hepatic parenchyma and the bifurcation of the anterior and posterior Glissonean pedicles, then the anterior or posterior Glisonean pedicle is extrahepatically encircled (Fig. 5) [10,11]. Hepatic parenchymal dissection along the Cantle line facilitates inserting an endocopic stapler and dividing the right anterior and posterior Glissonean pedicles respectively ( …”

A Simple Technique for Large Tumor Removal During Laparoscopic Liver Resection

“…[2][3][4][5][6][7] Briefly, the patient is placed in a left semilateral decubitus position for right liver resection and supine position for left liver resections. The surgeon stands between the patient's legs.…”

“…Some authors used suprapubic incision, whereas others use midline or subcostal incisions. [2][3][4][5][6] The size of the liver specimen is usually a limitation for the use of laparoscopy. The aim of this paper is to describe a new technique combining Pfannenstiel suprapubic incision and obstetric forceps to remove a large specimen from laparoscopic liver resections.…”