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Surgery Today

, 41:1592 | Cite as

Pure laparoscopic right hepatectomy in the semi-prone position using the intrahepatic Glissonian approach and a modified hanging maneuver to minimize intraoperative bleeding

  • Tetsuo Ikeda
  • Yusuke Yonemura
  • Naoyuki Ueda
  • Akira Kabashima
  • Ken Shirabe
  • Akinobu Taketomi
  • Tomoharu Yoshizumi
  • Hideaki Uchiyama
  • Noboru Harada
  • Hideki Ijichi
  • Yosihiro Kakeji
  • Masaru Morita
  • Shunichi Tsujitani
  • Yoshihiko Maehara
Original Article

Abstract

Purpose

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.

Methods

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).

Results

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).

Conclusion

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 words

Semi-prone position Laparoscopy Liver resection Right hepatectomy Minimal bleeding 

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Copyright information

© Springer 2011

Authors and Affiliations

  • Tetsuo Ikeda
    • 1
  • Yusuke Yonemura
    • 2
  • Naoyuki Ueda
    • 2
  • Akira Kabashima
    • 3
  • Ken Shirabe
    • 1
  • Akinobu Taketomi
    • 1
  • Tomoharu Yoshizumi
    • 1
  • Hideaki Uchiyama
    • 1
  • Noboru Harada
    • 1
  • Hideki Ijichi
    • 1
  • Yosihiro Kakeji
    • 1
  • Masaru Morita
    • 1
  • Shunichi Tsujitani
    • 1
  • Yoshihiko Maehara
    • 1
  1. 1.Department of Surgery and Science, Graduate School of Medical SciencesKyushu UniversityFukuokaJapan
  2. 2.Department of SurgeryOita Prefectural HospitalOitaJapan
  3. 3.Department of SurgeryKyushu Chuo HospitalFukuokaJapan

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