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Annals of Surgical Oncology

, Volume 24, Issue 6, pp 1606–1609 | Cite as

Three-Dimensional Laparoscopic Anatomical Segment 8 Liver Resection with Glissonian Approach

  • Jae Yool Jang
  • Ho-Seong HanEmail author
  • Yoo Seok Yoon
  • Jai Young Cho
  • YoungRok Choi
  • Woohyung Lee
  • Hong Kyung Shin
  • Han Lim Choi
Hepatobiliary Tumors

Abstract

Background

Anatomical liver resection has been reported to have oncologic benefit over nonanatomical resection in surgery for hepatocellular carcinoma (HCC). Basic concept of anatomical resection is preventing tumor spread through the portal or venous flow. Few cases have been reported for laparoscopic anatomical segment 8 resection because of its technical difficulties. This video shows operative techniques for laparoscopic anatomical resection of segment 8, exposing middle and right hepatic vein and inferior vena cava using three-dimensional video.

Methods

A 61-year-old male was diagnosed to be a hepatitis B virus carrier 6 years ago. A 6.6-cm-sized HCC lesion was detected at segment 8 by computed tomography scan. We have used a high-definition, three-dimensional laparoscope with a deflectable tip (Olympus Medical Systems Corp., Japan), a trocar inserted in the right seventh intercostal space to obtain the optimal field of view on the superior-posterior portion of the liver. Using the Glissonian pedicle approach, we isolated and clamped the branch to the segment 8 to confirm the anatomical border of the segment 8. Segmentectomy was completed exposing the middle and right hepatic vein and inferior vena cava.

Results

Operation took 420 min. Estimated blood loss was 600 mL, and no red blood cell was transfused. Final pathology was an HCC with 0.3-cm safety margin. The patient discharged on the sixth day after operation with normal liver function test results. There was no operation-related complication from the operation day to the first outpatient visit day.

Conclusions

Laparoscopic anatomical resection of segment 8 is feasible.

Keywords

Inferior Vena Cava Laparoscopic Liver Resection Middle Hepatic Vein Right Hepatic Vein Nonanatomical Resection 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Supplementary material

Supplementary material 1 (AVI 274523 kb)

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Copyright information

© Society of Surgical Oncology 2017

Authors and Affiliations

  • Jae Yool Jang
    • 1
  • Ho-Seong Han
    • 2
    Email author
  • Yoo Seok Yoon
    • 2
  • Jai Young Cho
    • 2
  • YoungRok Choi
    • 2
  • Woohyung Lee
    • 3
  • Hong Kyung Shin
    • 4
  • Han Lim Choi
    • 5
  1. 1.Department of SurgeryGyeongsang National University HospitalJinjuKorea
  2. 2.Department of Surgery, Seoul National University Bundang HospitalSeoul National University College of MedicineSeoulKorea
  3. 3.Department of SurgeryGyeongsang National University School of MedicineJinjuKorea
  4. 4.Department of SurgeryThe Armed Forces Medical CommandSeongnam-siKorea
  5. 5.Department of SurgeryChungbuk National University HospitalCheongjuKorea

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