Pure laparoscopic right hepatectomy in the semi-prone position using the intrahepatic Glissonian approach and a modified hanging maneuver to minimize intraoperative bleeding
- 386 Downloads
Although laparoscopic liver resection has been widely adopted, performing a pure laparoscopic right hepatectomy remains a challenging procedure. The aim of this report is to evaluate the efficiency of a pure laparoscopic right hepatectomy (PLRH) in the semi-prone position using the intrahepatic Glissonian approach and a modified hanging maneuver.
Pure laparoscopic right hepatectomy was performed in the semi-prone position with the use of an intrahepatic Glissonian approach and modified hanging maneuver for patients with primary liver cancer (n = 3) and metastatic liver cancer (n = 1).
The intraoperative total blood loss was only 95–140 g (mean: 126.2 g). None of the patients required a blood transfusion, and no serious complications were encountered. The durations of the surgeries ranged from were 308 to 445 min (mean: 394.8 min). The postoperative hospital stay was 8–11 days (mean 9.5 days).
Pure laparoscopic right hepatectomy in the semi-prone position using the intrahepatic Glissonian approach and a modified hanging maneuver is thus considered to be a safe modality, which minimizes intraoperative bleeding.
Key wordsSemi-prone position Laparoscopy Liver resection Right hepatectomy Minimal bleeding
- 19.Lee KF, Wong J, Ng W, Cheung YS, Lai P. Feasibility of liver resection without the use of the routine Pringle maneuver: an analysis of 248 consecutive cases. HPB (Oxford) 2009;11(4):332–338.Google Scholar
- 20.Kaneko H, Otsuka Y, Tsuchiya M, Tamura A, Katagiri T, Yamazaki K. Application of devices for safe laparoscopic hepatectomy. HPB (Oxford) 2008;10(4):219–224.Google Scholar
- 25.Abu Hilal M, Underwood T, Taylor MG, Hamdan K, Elberm H, Pearce NW. Bleeding and hemostasis in laparoscopic liver surgery. Surg Endosc; 24(3):572–577.Google Scholar