Safe and feasible inflow occlusion in laparoscopic liver resection

Cho, Akihiro; Yamamoto, Hiroshi; Nagata, Michio; Takiguchi, Nobuhiro; Shimada, Hideaki; Kainuma, Osamu; Souda, Hiroaki; Gunji, Hisashi; Miyazaki, Akira; Ikeda, Atsushi; Matsumoto, Ikuko

doi:10.1007/s00464-008-0257-6

Cited by 33 publications

(14 citation statements)

References 9 publications

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“…1,23,24 In conclusion, the Tri-Staple technology in laparoscopic liver resection is safe and feasible for the resection of liver segments. The contribution of this new technology and a completed learning curve account for a favorable outcome with minimal morbidity especially when approaching P-S segments and in complex cases of major hepatectomy.…”

Section: Discussionmentioning

confidence: 83%

Tissue Management With Tri-Staple Technology in Major and Minor Laparoscopic Liver Resections

Scuderi

Troisi

2014

International Surgery

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One of the most relevant technologic advancements in laparoscopic liver resection (LLR) is owing to the improved ability to safely secure and divide vascular and biliary structures and the liver parenchyma by the use of endostaplers. We compared, retrospectively, 35 LLRs with the Tri-Staple technology versus 57 LLRs without, during a 14-month period. Colorectal liver metastases were overall the main indication for LLR. Neither major hepatectomy nor left lateral sectionectomy was done in the nonstapled group. Mean surgical time and blood loss were similar, whereas the tumor number and size were significantly larger in the stapled group (P 0.01). The conversion rate was 0% and 3.5% (n ¼ 2); and the morbidity rate was 9% (n ¼ 3) and 12% (n ¼ 7), respectively, in the stapled and nonstapled group (P ¼ 0.8). No overall 3-month mortality was recorded. Endo GIA Reloads with Tri-Staple technology allow a proper division of the intrahepatic vessels and biliary structure. These devices in LLRs are safe and feasible, allowing major hepatectomy and complex cases as 2-staged procedures and laparoscopic living donor liver resections.

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Section: Discussionmentioning

confidence: 83%

Tissue Management With Tri-Staple Technology in Major and Minor Laparoscopic Liver Resections

Scuderi

Troisi

2014

International Surgery

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“…Most surgical teams use a 10-14 mmHg pneumoperitoneum [13][14][15][16][17][18][19][20][21][22][23][24], which allows a good control of bleeding (Grade C). In a case-match analysis Tranchart et al [6] suggested that the positive pressure of pneumoperitoneum was probably the main factor explaining the decreased blood loss during laparoscopy when compared to open liver surgery (Grade C).…”

Section: Pneumoperitoneummentioning

confidence: 99%

Bleeding control during laparoscopic liver resection: a review of literature

Tranchart

O’Rourke

Dam

et al. 2015

J Hepatobiliary Pancreat Sci

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Despite the established advantages of laparoscopy, bleeding control during laparoscopic liver resection (LLR) is a liver-specific improvement. The 2nd International Consensus Conference on Laparoscopic Liver Resection was held in October 2014 at Morioka, Japan. One of the most capital questions was: What is essential in bleeding control during LLR? In order to correctly address this question, we conducted a comprehensive review of the literature. Essential points based on personal experience of the expert panel are also discussed. A total of 54 publications were identified. Based on this analysis, the working group built these recommendations: (1) a pneumoperitoneum of 10-14 mmHg should be used as it allows a good control of the bleeding without significant modifications of hemodynamics; (2) a low central venous pressure (<5 mmHg) should be used; (3) laparoscopy facilitates inflow and outflow control; and (4) surgeons should be experienced with the use of all surgical devices for liver transection and should master laparoscopic suture before starting LLR. Precoagulation with radiofrequency can be useful, particularly in cases of atypical resection. These recommendations are mostly based on experts' opinions and on B or C quality of evidence grade studies. More prospective data are required to confirm these results.

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“…1) or Endo Mini-Retract (Covidien Japan, Tokyo, Japan) to be used as a tourniquet for complete interruption of blood inflow to the liver only if necessary [9]. www.intechopen.com 2.1 Encircling right-sided Glissonean pedicles, including the right, anterior, and posterior pedicles After dividing the cystic artery and duct and dissecting the gallbladder neck, the peritoneum of the hepatoduodenal ligament is dissected at the hepatic hilum (Fig.…”

Section: Surgical Techniquementioning

confidence: 99%