Journal of Hepato-Biliary-Pancreatic Surgery

, Volume 13, Issue 2, pp 149–154

Laparoscopic left lateral hepatic lobectomy: a safer and faster technique

  • Giulio Belli
  • Corrado Fantini
  • Alberto D'Agostino
  • Andrea Belli
  • Luigi Cioffi
  • Nadia Russolillo
Surgeon at work

DOI: 10.1007/s00534-005-1023-y

Cite this article as:
Belli, G., Fantini, C., D'Agostino, A. et al. J Hepatobiliary Pancreat Surg (2006) 13: 149. doi:10.1007/s00534-005-1023-y
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Abstract

Background/Purpose

Laparoscopy for liver resection is highly specialized field because laparoscopic liver surgery presents severe technical difficulties, such as control of bleeding and risk of gas embolism. At present, a limited number of laparoscopic anatomical left lobectomies have been reported in the literature, but we believe that the use of stapling devices has made this technique safer and faster.

Methods

From January 2000 to May 2005, eight patients (five men, three women; mean age, 60.5 years) underwent laparoscopic anatomical left lobectomy at our department. Seven patients presented with hepatocellular carcinoma and cirrhosis, while one patient had a large symptomatic angioma. The average size of the lesions was 4.18 cm (range, 3.6–7.1 cm); all the lesions were localized in the anatomical left lobe (segments II–III). Transection of the liver parenchyma, together with sectioning of the vascular pedicle for segment II and III and of the left hepatic vein, was obtained by the use of stapling devices.

Results

The mean operative time was 142 min (range, 120–180 min). There were no intraoperative or postoperative complications, and blood transfusions were not required. The mean postoperative hospital stay was 5.75 days.

Conclusions

The key points of the technique are: late mobilization of the liver; no transection of the round ligament; no surrounding or taping of the portal pedicles or of the left hepatic vein; and the use of three consecutive linear staplers, turned to the left for transecting the liver parenchyma and vascular pedicle together. This technique, in our opinion, should be considered a new good option for patients with isolated lesions of the left lateral segments, but it must be performed by surgeons trained in both liver and advanced laparoscopic surgery.

Key words

Laparoscopic liver resection Left lobectomy Stapler HCC Cirrhosis 

Copyright information

© Springer-Verlag Tokyo 2006

Authors and Affiliations

  • Giulio Belli
    • 1
  • Corrado Fantini
    • 1
  • Alberto D'Agostino
    • 1
  • Andrea Belli
    • 1
  • Luigi Cioffi
    • 1
  • Nadia Russolillo
    • 1
  1. 1.Department of General and Hepato-Pancreato-Biliary SurgeryS.M. Loreto Nuovo HospitalNaplesItaly
  2. 2.NaplesItaly

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