Laparoscopic major resections remain a challenge for liver surgeons. This video illustrates, step by step, our laparoscopic technique for left hepatectomy.
The control of vascular inflow and outflow as well as the division of the left hepatic duct were carried out extraparenchymally before liver transection. Between 2002 and 2008, 11 left hepatectomies were performed by laparoscopy: 7 for liver tumor and 4 for localized Caroli’s disease.
Mean duration of surgery was 248 ± 25 min. Mean operative blood loss was 129 ± 42 ml. Intraoperative blood transfusion or conversion to laparotomy were never required. One postoperative biliary collection occurred and was drained percutaneously. None of the patients died. Mean hospital stay was 7.6 ± 2.2 days.
This technique has proved to be safe and easily reproducible.
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Di Giuro, G., Lainas, P., Franco, D. et al. Laparoscopic left hepatectomy with prior vascular control. Surg Endosc 24, 697–699 (2010). https://doi.org/10.1007/s00464-009-0613-1
- Left hepatectomy
- Vascular control
- Extraparenchymal control
- Major resection