Totally Laparoscopic Right Hepatectomy Combined with Resection of the Inferior Vena Cava by Anterior Approach

Nomi, Takeo; Fuks, David; Agrawal, Amit; Kawaguchi, Yoshikuni; Ogiso, Satoshi; Gayet, Brice

doi:10.1245/s10434-014-4030-x

Cited by 25 publications

(11 citation statements)

References 5 publications

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“…Stable and adequate exposure is a key element of LRH, but it is difficult to achieve and maintain using the common approach. Some surgeons used an anterior approach to perform LRH to avoid poor surgical field exposure, but this approach is not suitable for local liver excision in complicated locations.…”

Section: Discussionmentioning

confidence: 99%

A novel exposure maneuver in laparoscopic right hepatectomy

Shen

Zhang

Sun

et al. 2019

Journal of Surgical Oncology

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Background and objectives Laparoscopic access to the posterosuperior and lateral parts of the right liver is difficult for blocked and deep surgical situations. We invented a novel water bag device (WBD) to improve the exposure of the right liver. Methods Eighteen consecutive patients with lesions isolated to the posterosuperior or lateral right liver were included in our research. They underwent laparoscopic right hepatectomy with the help of the device and were compared with previous similar laparoscopic cases of our operating surgeon. Results The device was successfully employed without related complications and provided enhanced and stable surgical exposure. All patients were operated on without the need for blood transfusions or laparotomy conversion. The median operation time and estimated blood loss were 227 minutes (range, 114‐568) and 88 mL (range, 25‐250), respectively. In all cases, tumor‐free surgical margins were confirmed and no major complications were observed. The results were better than those in previous similar laparoscopic cases. Conclusions The WBD is safe and effective for laparoscopic exposure when lesions are located in the posterosuperior and lateral parts of the right liver. With the help of the device, laparoscopic right liver resection is easier to perform instead of undergoing open hepatectomy.

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Section: Discussionmentioning

confidence: 99%

A novel exposure maneuver in laparoscopic right hepatectomy

Shen

Zhang

Sun

et al. 2019

Journal of Surgical Oncology

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“…Good exposure of the hepatic lesion is the pre-condition for a successful laparoscopic hepatectomy [17]. In this study, we employed this novel position—the left jackknife position—in laparoscopic hepatectomy, allowing gravity to pull and rotate the liver and full exposure of lesions located in the posterior lobe (including liver segment VI, VII, or VIII) and the retrohepatic tunnel.…”

Section: Discussionmentioning

confidence: 99%

Left jackknife position: a novel position for laparoscopic hepatectomy

et al. 2017

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BackgroundLaparoscopic hepatectomy for hepatocellular carcinoma (HCC) located in segment VI, VII, or VIII of the liver is usually difficult because of poor operative exposure, due to the unique anatomical structure. In this study, we evaluated the practice of laparoscopic hepatectomy with the left jackknife position for patients with HCC located in segment VI, VII, or VIII.MethodsA total of 10 patients were enrolled to undergo laparoscopic hepatectomy with the left jackknife position. Tumors located in segment VI, VII, or VIII were assessed by preoperative dynamic computed tomography or magnetic resonance imaging. Operation time, intraoperative blood loss, postoperative fasting time, postoperative drainage time, major postoperative complications, and duration of postoperative hospital stay were recorded.ResultsAll surgeries were successfully completed. None of the patients required conversion to open surgery during the procedure, and no serious postoperative complications were observed. The median tumor size was 31 mm (range 23–41 mm) in diameter, the mean operation time was 166 ± 38 min, the mean intraoperative blood loss was 220 ± 135 mL, and the median postoperative hospital stay was 4 days (range 2–7 days).ConclusionsFor HCC located in segment VI, VII, or VIII, laparoscopic hepatectomy with this novel position—the left jackknife position—is safe and effective during tumor resection by exposing a sufficient operating field. Trial registration ClinicalTrials.gov ID: NCT02809287

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“…[11][12][13][18][19][20][21][22][23][24][25][26] Liver resectability was always confirmed by intraoperative ultrasonography. Major hepatectomy was defined as the resection of 3 or more contiguous segments.…”

Section: Surgical Proceduresmentioning

confidence: 92%