The Southampton Consensus Guidelines for Laparoscopic Liver Surgery

Hilal, Mohammed Abu; Aldrighetti, Luca; Dagher, Ibrahim; Edwin, Bjørn; Troisi, Roberto; Alikhanov, Ruslan; Aroori, Somaiah; Belli, Giulio; Besselink, Marc G.; Briceño, Javier; Gayet, Brice; D’Hondt, Mathieu; Lesurtel, Mickaël; Menon, Krishna; Lodge, Peter; Rotellar, Fernando; Santoyo, Julio Santoyo; Scatton, Olivier; Soubrane, Olivier; Sutcliffe, Robert P.; Dam, Ronald M. van; White, Steve; Halls, Mark; Cipriani, Federica; Poel, M. van der; Ciria, Rubén; Barkhatov, Leonid; Gomez-Luque, Yrene; Ocana-Garcia, Sira; Cook, Andrew; Buell, Joseph F.; Clavien, Pierre‐Alain; Dervenis, Christos; Fusai, Giuseppe; Geller, David A.; Lang, Hauke; Primrose, John; Mb, Taylor; Gulik, Thomas van; Wakabayashi, Go; Asbun, Horacio J.; Cherqui, Daniel

doi:10.1097/sla.0000000000002524

Cited by 516 publications

(418 citation statements)

References 79 publications

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“…Most likely, the perceived risks for the donors, the complexity of the procedures, the variability of the learning curve, the relatively small number of indications for pediatric transplantation, and the competing split‐liver policies are the main causes hindering the development of the laparoscopic approach. Consequently, more robust data on short‐term and longterm outcomes are required before promoting the implementation of the laparoscopy as highlighted by the 2nd ICCLLS and by the European Guidelines Meeting on Laparoscopic Liver Surgery . National and international registries could possibly provide meaningful data by allowing for a risk‐benefit analysis .…”

Section: Discussionmentioning

confidence: 99%

Pure Laparoscopic Living Donor Left Lateral Sectionectomy in Pediatric Transplantation: A Propensity Score Analysis on 220 Consecutive Patients

et al. 2018

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Left lateral sectionectomy for donor hepatectomy is a well-established alternative to deceased donor pediatric liver transplantation. However, very little is available on the laparoscopic approach (laparoscopic left lateral sectionectomy [L-LLS]). With the aim to assess safety, reproducibility under proctorship, and outcomes following living donor liver transplantation in children, a comparative single-center series using propensity score matching (PSM) to evaluate open left lateral sectionectomy (O-LLS) versus L-LLS was carried out in a relatively short time period in a high-volume pediatric transplant center. A retrospective, observational, single-center, PSM study was conducted on 220 consecutive living donor hepatectomies from January 2011 to April 2017. The variables considered for PSM were as follows: year of operation, recipient age, indication for transplant, recipient weight, donor sex, donor age, and donor body mass index. After matching, 72 O-LLSs were fit to be compared with 72 L-LLSs. Operative time and warm ischemia time were significantly longer in L-LLSs, whereas blood loss and overall donor complication rates were significantly lower. Postoperative day 1 and 4 pain scores were significantly less in the L-LLS group (P = 0.015 and 0.003, respectively). The length of hospital stay was significantly shorter in L-LLS (4.6 versus 4.1 days; P = 0.014). Overall donor biliary complications were 9 (12.5%) and 1 (1.4%) for O-LLS and L-LLS (P = 0.022), respectively. Vascular complications occurred in 3 (4.2%) children without graft loss in the laparoscopic group. The 1-, 3-, and 5-year overall patient survival rates were 98.5%, 90.9%, and 90.9% in the O-LLS group and in the L-LLS group 94.3%, 92.7%, and 86.8% (P = 0.28). In conclusion, L-LLS for donor hepatectomy is a safe and reproducible technique yielding better donor perioperative outcomes with respect to the conventional approach with similar recipient outcomes.

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Section: Discussionmentioning

confidence: 99%

Pure Laparoscopic Living Donor Left Lateral Sectionectomy in Pediatric Transplantation: A Propensity Score Analysis on 220 Consecutive Patients

et al. 2018

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“…However, a full left liver graft may be considered when graft volume is deemed adequate for the recipient. Since the initiation of PLDH using the left lateral section in 2001, the recommended procedure is pure laparoscopic donor left lateral sectionectomy because of its similar safety results to open surgery and the advantages of minimally invasive surgery . With the accumulation of experience and the continuing development of surgical instruments and techniques, PLDRH is increasingly performed in experienced centers .…”

Section: Discussionmentioning

confidence: 99%

Pure Laparoscopic Versus Open Left Hepatectomy Including the Middle Hepatic Vein for Living Donor Liver Transplantation

et al. 2020

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Pure laparoscopic donor hepatectomy (PLDH) has become increasingly accepted in the era of minimally invasive surgeries. However, the outcomes of pure laparoscopic donor left hepatectomy (PLDLH) are relatively less known than for left lateral sectionectomy or right hepatectomy. This study aimed to report our experience with and the outcomes of PLDLH including the middle hepatic vein (MHV) and to compare these outcomes with conventional donor left hepatectomy (CDLH). The medical records of living liver donors between January 2010 and January 2018 at Seoul National University Hospital were retrospectively reviewed. Donors who underwent left hepatectomy including the MHV were included. To minimize selection bias, donors who underwent CDLH after the initiation of the PLDH program were excluded. Finally, there were 18 donors who underwent CDLH and 8 who underwent PLDLH. The median (interquartile range [IQR]) warm ischemia time (11 [10‐16] minutes versus 4 [2‐7] minutes; P = 0.001) was longer in the PLDLH group than the CDLH group. The total operation time (333 [281‐376] minutes versus 265 [255‐308] minutes; P = 0.09) and time to remove the liver (245 [196‐276] minutes versus 182 [172‐205] minutes; P = 0.08) were also longer in PLDLH although not statistically significant. The length of postoperative hospital stay was significantly shorter in the PLDLH group (7 [7‐8] days versus 9 [8‐10] days; P = 0.01). There were no postoperative complications in the PLDLH group. The rate of complications in recipients was similar in both groups. In conclusion, PLDLH including the MHV appears to be safe and feasible. Further analysis including longterm outcomes is needed.

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“…The importance of this consensus for robotic liver surgery was to demonstrate that there was non‐inferiority between the novel technology and the laparoscopic surgery . The European consensus and guideline showed that, even with a higher cost and prolonged surgical time, the robotic surgery offers a shorter hospitalization, minor blood loss, more free surgical margins, and morbidity comparable to laparoscopic surgery …”

Section: Discussionmentioning

confidence: 99%

Robotic approach as a valid strategy to improve the access to posterosuperior hepatic segments—Case series and review of literature

Araújo

Sanctis

Barroti

et al. 2020

Journal of Surgical Oncology

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Introduction Although the laparoscopy liver resection (LLR) has become a useful approach for minor resections, it seems that lesions in posterosuperior (PS) segments still represent technical challenges. We report a series of robotic approach as an alternative option for these lesions, and a systematic review of the literature to show its feasibility. Methods Consecutive patients who underwent liver resection for solitary lesions in PS segments by da Vinci SI robot, and by the same team. A systematic review of the literature was made to evaluate the feasibility of a robotic approach for PS hepatectomies. Results From April 2016 to April 2017, five cases of robotic nonanatomical PS resections of colorectal liver metastases (CRLM) were performed. A systematic review encountered five articles plus this series reporting outcomes for this approach. Briefly, a total of five patients in our series underwent this approach, all females, and one patient presented a grade 2 complication. Conclusion Robotic hepatectomy seems to be a useful and valid strategy to resect lesions on PS hepatic segments simplifying liver‐sparing hepatectomies. Even though the operative time is still high, the short length of stay, low number of complications and the low need for blood transfusions seems to surpass the intrinsic cost of robotic surgery.

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The Southampton Consensus Guidelines for Laparoscopic Liver Surgery

Cited by 516 publications

References 79 publications

Pure Laparoscopic Living Donor Left Lateral Sectionectomy in Pediatric Transplantation: A Propensity Score Analysis on 220 Consecutive Patients

Pure Laparoscopic Living Donor Left Lateral Sectionectomy in Pediatric Transplantation: A Propensity Score Analysis on 220 Consecutive Patients

Pure Laparoscopic Versus Open Left Hepatectomy Including the Middle Hepatic Vein for Living Donor Liver Transplantation

Robotic approach as a valid strategy to improve the access to posterosuperior hepatic segments—Case series and review of literature

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