Skip to main content
Log in

Laparoendoscopic single-site minor hepatectomy for liver tumors

  • Technique
  • Published:
Surgical Endoscopy Aims and scope Submit manuscript

Abstract

Background

Laparoscopic liver surgery is gaining increasing acceptance worldwide, but its frontiers are constantly challenged. Laparoendoscopic single-site surgery (LESS) has been performed for various organs, but the feasibility of LESS hepatectomies has yet to be explored fully.

Methods

From May 2010 to March 2011, seven patients underwent LESS minor hepatectomies. Patient demographic, operative, and clinical data were reviewed.

Results

Five left lateral sectionectomies, one segment 3, and one segment 5 resection were performed. The median operative time was 142 min (range, 104–171 min), and the median blood loss was 200 ml (range, 100–450 ml). The median hospital stay was 3 days (range, 1–11 days). For all the patients, the indications for surgery were suspected malignant tumors, and the surgical resection margins were clear for every patient.

Conclusions

Laparoendoscopic single-site minor hepatectomy is a novel modification to traditional laparoscopic surgery. The method is safe and feasible without any compromise to oncologic safety for selected patients with hepatocellular carcinoma (HCC) and colorectal liver metastases that are peripheral and smaller than 5 cm in size.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Buell JF, Cherqui D, Geller DA, O’Rourke N, Iannitti D, Koffron AJ, Thomas M, Gayet B, Han HS, Wakabayashi G, Belli G, Kaneko H, Ker CG, Scatton O, Laurent A, Abdalla EK, Chaudhury P, Dutson E, Gamblin C, D’Angelica M, Nagorney D, Testa G, Labow D, Manas D, Poon RT, Nelson H, Martin R, Clary B, Pinson WC, Martinie J, Vauthey JN, Goldstein R, Roayaie S, Barlet D, Espat J, Abecassis M, Rees M, Fong Y, McMasters KM, Broelsch C, Busuttil R, Belghiti J, Strasberg S, Chari RS (2009) The international position on laparoscopic liver surgery: the Louisville Statement, 2008. Ann Surg 250:825–830

    Article  PubMed  Google Scholar 

  2. Tracy CR, Raman JD, Cadeddu JA, Rane A (2008) Laparoendoscopic single-site surgery in urology: where have we been and where are we heading? Nat Clin Pract Urol 5:561–568

    Article  PubMed  Google Scholar 

  3. Tsimoyiannis EC, Tsimogiannis KE, Pappas-Gogos G, Farantos C, Benetatos N, Mavridou P, Manataki A (2010) Different pain scores in single transumbilical incision laparoscopic cholecystectomy versus classic laparoscopic cholecystectomy: a randomized controlled trial. Surg Endosc 24:1842–1848

    Article  PubMed  Google Scholar 

  4. Chang SK, Tay CW, Bicol RA, Lee YY, Madhavan K (2011) A case—control study of single-incision versus standard laparoscopic cholecystectomy. World J Surg 35:289–293

    Article  PubMed  Google Scholar 

  5. Chow A, Purkayastha S, Aziz O, Pefanis D, Paraskeva P (2010) Single-incision laparoscopic surgery for cholecystectomy: a retrospective comparison with 4-port laparoscopic cholecystectomy. Arch Surg 145:1187–1191

    Article  PubMed  Google Scholar 

  6. St Peter SD, Adibe OO, Juang D, Sharp SW, Garey CL, Laituri CA, Murphy JP, Andrews WS, Sharp RJ, Snyder CL, Holcomb GW III, Ostlie DJ (2011) Single-incision versus standard 3-port laparoscopic appendectomy: a prospective randomized trial. Ann Surg 254:586–590

    Article  PubMed  Google Scholar 

  7. Teoh AY, Chiu PW, Wong TC, Wong SK, Lai PB, Ng EK (2011) A case-controlled comparison of single-site access versus conventional three-port laparoscopic appendectomy. Surg Endosc 25:1415–1419

    Article  PubMed  Google Scholar 

  8. Tai HC, Lin CD, Chung SD, Chueh SC, Tsai YC, Yang SS (2011) A comparative study of standard versus laparoendoscopic single-site surgery (LESS) totally extraperitoneal (TEP) inguinal hernia repair. Surg Endosc 25:2879–2883

    Article  PubMed  Google Scholar 

  9. Seo IY, Lee JW, Rim JS (2011) Laparoendoscopic single-site radical nephrectomy: a comparison with conventional laparoscopy. J Endourol 25:465–469

    Article  PubMed  Google Scholar 

  10. Stein RJ, Berger AK, Brandina R, Patel NS, Canes D, Irwin BH, Aron M, Autorino R, Shah G, Desai MM (2011) Laparoendoscopic single-site pyeloplasty: a comparison with the standard laparoscopic technique. Br J Urol Int 107:811–815

    Article  Google Scholar 

  11. Canes D, Berger A, Aron M, Brandina R, Goldfarb DA, Shoskes D, Desai MM, Gill IS (2010) Laparoendoscopic single site (LESS) versus standard laparoscopic left donor nephrectomy: matched-pair comparison. Eur Urol 57:95–101

    Article  PubMed  Google Scholar 

  12. Kobayashi S, Nagano H, Marubashi S, Wada H, Eguchi H, Takeda Y, Tanemura M, Sekimoto M, Doki Y, Mori M (2010) A single-incision laparoscopic hepatectomy for hepatocellular carcinoma: initial experience in a Japanese patient. Minim Invasive Ther Allied Technol 19:367–371

    Article  PubMed  Google Scholar 

  13. Patel AG, Belgaumkar AP, James J, Singh UP, Carswell KA, Murgatroyd B (2011) Single-incision laparoscopic left lateral segmentectomy of colorectal liver metastasis (video). Surg Endosc 25:649–650

    Article  PubMed  Google Scholar 

  14. Aldrighetti L, Guzzetti E, Ferla G (2011) Laparoscopic hepatic left lateral sectionectomy using the laparoendoscopic single-site approach: evolution of minimally invasive liver surgery. J Hepatobiliary Pancreat Sci 18:103–105

    Article  PubMed  Google Scholar 

  15. Gaujoux S, Kingham TP, Jarnagin WR, D’Angelica MI, Allen PJ, Fong Y (2010) Single-incision laparoscopic liver resection. Surg Endosc 25:1489–1494

    Article  PubMed  Google Scholar 

  16. Thelen A, Benckert C, Jonas S, Lopez-Hanninen E, Sehouli J, Neumann U, Rudolph B, Neuhaus P (2008) Liver resection for metastases from breast cancer. J Surg Oncol 97:25–29

    Article  PubMed  Google Scholar 

  17. Poon RT, Fan ST, Ng IO, Wong J (2000) Significance of resection margin in hepatectomy for hepatocellular carcinoma: a critical reappraisal. Ann Surg 231:544–551

    Article  PubMed  CAS  Google Scholar 

  18. Hashizume M, Migo S, Tsugawa K, Tanoue K, Ohta M, Sugimachi K (1998) Laparoscopic splenectomy with the newly devised morcellator. Hepatogastroenterology 45:554–557

    PubMed  CAS  Google Scholar 

  19. Kim YW, Park BJ, Ro DY, Kim TE (2010) Single-port laparoscopic myomectomy using a new single-port transumbilical morcellation system: initial clinical study. J Minim Invasive Gynecol 17:587–592

    Article  PubMed  Google Scholar 

  20. Papaconstantinou HT, Thomas JS (2011) Single-incision laparoscopic colectomy for cancer: assessment of oncologic resection and short-term outcomes in a case-matched comparison with standard laparoscopy. Surgery 150:820–827

    Article  PubMed  Google Scholar 

Download references

Disclosures

Ek Khoon Tan, Victor Tswen-Wen Lee, Stephen Kin Yong Chang, Iyer Shridhar Ganpathi, Krishnakumar Madhavan and Davide Lomanto have no conflicts of interest or financial ties to disclose.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Victor Tswen-Wen Lee.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Tan, E.K., Lee, V.TW., Chang, S.K.Y. et al. Laparoendoscopic single-site minor hepatectomy for liver tumors. Surg Endosc 26, 2086–2091 (2012). https://doi.org/10.1007/s00464-011-2128-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00464-011-2128-9

Keywords

Navigation