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

  • Hepatobiliary Tumors
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

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.

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Author information

Authors and Affiliations

  1. Department of Surgery, Gyeongsang National University Hospital, Jinju, Korea

    Jae Yool Jang MD

  2. Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seoul, Korea

    Ho-Seong Han MD, PhD, Yoo Seok Yoon MD, PhD, Jai Young Cho MD, PhD & YoungRok Choi MD

  3. Department of Surgery, Gyeongsang National University School of Medicine, Jinju, Korea

    Woohyung Lee MD

  4. Department of Surgery, The Armed Forces Medical Command, Seongnam-si, Korea

    Hong Kyung Shin MD

  5. Department of Surgery, Chungbuk National University Hospital, Cheongju, Korea

    Han Lim Choi MD

Authors
  1. Jae Yool Jang MD
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  2. Ho-Seong Han MD, PhD
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  3. Yoo Seok Yoon MD, PhD
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  4. Jai Young Cho MD, PhD
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  5. YoungRok Choi MD
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  6. Woohyung Lee MD
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  7. Hong Kyung Shin MD
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  8. Han Lim Choi MD
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Corresponding author

Correspondence to Ho-Seong Han MD, PhD.

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Jang, J.Y., Han, HS., Yoon, Y.S. et al. Three-Dimensional Laparoscopic Anatomical Segment 8 Liver Resection with Glissonian Approach. Ann Surg Oncol 24, 1606–1609 (2017). https://doi.org/10.1245/s10434-017-5778-6

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  • DOI: https://doi.org/10.1245/s10434-017-5778-6

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