Document Detail


Laparoscopic hand-assisted right hemihepatectomy by ultrasound-directed intrahepatic approach.
MedLine Citation:
PMID:  19779667     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
BACKGROUND/PURPOSE: Laparoscopic hepatectomy is a promising option for patients affected by a liver mass, and the procedure is gaining popularity. Minor laparoscopic resections have been widely reported. In contrast, major laparoscopic hepatectomy has been performed in only a limited number of cases. Hand-assisted laparoscopic liver surgery has been advocated in order to improve liver exposure and vascular control and increase the safety of the procedure. Transparenchymal en-bloc transection of the right portal triad has been reported to be safe and useful in open surgery. METHODS: We describe a personal technique for hand-assisted right hemihepatectomy. With ultrasound guidance, the right hepatic pedicle is isolated intrahepatically and transected en bloc with a single firing of an endostapler. Parenchymal transection is carried out with ultrasonically activated or vessel-sealing devices together with endostaplers. RESULTS: The procedure was successfully accomplished in three patients. The Pringle maneuver was never performed. No intraoperative or postoperative complications occurred. CONCLUSION: This study is the first to report a technique of right hemihepatectomy that combines hand-assisted laparoscopy and an ultrasound-guided intrahepatic approach. This technique may be a useful option to simplify the operation, reduce operative time, and increase the safety of the procedure.
Authors:
Giulio Belli; Alberto D'Agostino; Corrado Fantini; Andrea Belli; Luigi Cioffi; Paolo Limongelli; Gianluca Russo
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of hepato-biliary-pancreatic surgery     Volume:  16     ISSN:  1436-0691     ISO Abbreviation:  J Hepatobiliary Pancreat Surg     Publication Date:  2009  
Date Detail:
Created Date:  2009-12-07     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9431940     Medline TA:  J Hepatobiliary Pancreat Surg     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  781-5     Citation Subset:  IM    
Affiliation:
Department of General and Hepato-Pancreato-Biliary Surgery, S.M. Loreto Nuovo Hospital, Naples, Italy. chirurgia.loretonuovo@tin.it
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