Skip to main content
Log in

Single-Port and Multi-Port Laparoscopic Left Lateral Liver Sectionectomy for Treating Benign Liver Diseases: A Prospective, Randomized, Controlled Study

  • Published:
World Journal of Surgery Aims and scope Submit manuscript

Abstract

Background

The use of single-port laparoscopy for left-lateral liver sectionectomy (LLLS) has been reported in the literature, but the effectiveness and safety of LLLS has not been validated in randomized, controlled trials. This prospective randomized controlled trial compared the effectiveness and safety of single-port and multi-port laparoscopic LLLS for the surgical treatment of benign liver disease.

Methods

Altogether, 38 patients aged 17–65 years (16 men, 22 women) with benign liver diseases were hospitalized for elective laparoscopic LLLS between January 2010 and December 2012. Patients were randomly assigned to either single-port (n = 19) or multi-port (n = 19) laparoscopic LLLS. Main outcome measures were operative time, volume of intraoperative blood loss, complication rates, and postoperative hospitalization.

Results

Baseline characteristics of the two groups were comparable. Single-port and multi-port laparoscopies were successfully completed in all but one patient (1/19, 5.3 %) who required conversion from a single-port to a multi-port procedure. The two groups had similar mean operative times and volumes of intraoperative blood loss. There were no clinically significant postoperative complications or deaths. The single-port group had a significantly shorter postoperative hospitalization than the multi-port group (2.5 ± 1.7 vs. 4.0 ± 2.1 days; p < 0.05).

Conclusions

Single-port laparoscopic LLLS is a technically feasible, effective, safe alternative to multi-port laparoscopy for the treatment of benign liver diseases in cautiously selected patients.

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.

Similar content being viewed by others

References

  1. Etoh T, Yasuda K, Inomata M et al (2010) Current status of laparoscopic gastrectomy for gastric malignancies. Surg Technol Int 20:153–157

    PubMed  Google Scholar 

  2. González QH, Rodríguez-Zentner HA, Moreno-Berber JM et al (2009) Laparoscopic versus open total mesorectal excision: a nonrandomized comparative prospective trial in a tertiary center in Mexico City. Am Surg 75:33–38

    PubMed  Google Scholar 

  3. Dagher I, Lainas P, Carloni A et al (2008) Laparoscopic liver resection for hepatocellular carcinoma. Surg Endosc 22:372–378

    Article  PubMed  Google Scholar 

  4. Cha EK, Lee DJ, Del Pizzo JJ (2011) Current status of robotic partial nephrectomy (RPN). BJU Int 108:935–941

    Article  PubMed  Google Scholar 

  5. Rosales-Velderrain A, Stauffer JA, Bowers SP et al (2012) Current status of laparoscopic distal pancreatectomy. Minerva Gastroenterol Dietol 58:239–252

    PubMed  CAS  Google Scholar 

  6. Abu Hilal M, McPhail MJ, Zeidan B et al (2008) Laparoscopic versus open left lateral hepatic sectionectomy: a comparative study. Eur J Surg Oncol 34:1285–1288

    Article  PubMed  CAS  Google Scholar 

  7. Podolsky ER, Rottman SJ, Curcillo PG 2nd (2009) Single port access (SPA) cholecystectomy: two year follow-up. J Soc Laparoendosc Surg (JSLS) 13:528–535

    Article  Google Scholar 

  8. Canes D, Desai MM, Aron M et al (2008) Transumbilical single-port surgery: evolution and current status. Eur Urol 54:1020–1029

    Article  PubMed  Google Scholar 

  9. Saad S, Strassel V, Sauerland S (2013) Randomized clinical trial of single-port, minilaparoscopic and conventional laparoscopic cholecystectomy. Br J Surg 100:339–349

    Article  PubMed  CAS  Google Scholar 

  10. Frutos MD, Abrisqueta J, Lujan J et al (2013) Randomized prospective study to compare laparoscopic appendectomy versus umbilical single-incision appendectomy. Ann Surg 257:413–418

    Article  PubMed  Google Scholar 

  11. Fanfani F, Fagotti A, Gagliardi ML et al (2013) Minilaparoscopic versus single-port total hysterectomy: a randomized trial. J Minim Invasive Gynecol 20:192–197

    Article  PubMed  Google Scholar 

  12. Park Do J, Lee JH, Ahn SH et al (2012) Single-port laparoscopic distal gastrectomy with D1+β lymph node dissection for gastric cancers: report of 2 cases. Surg Laparosc Endosc Percutan Tech 22:e214–e216

    Article  PubMed  Google Scholar 

  13. Nguyen KT, Gamblin TC, Geller DA (2009) World review of laparoscopic liver resection: 2,804 patients. Ann Surg 250:831–841

    Article  PubMed  Google Scholar 

  14. Rao A, Rao G, Ahmed I (2011) Laparoscopic left lateral liver resection should be a standard operation. Surg Endosc 25:1603–1610

    Article  PubMed  Google Scholar 

  15. Cheung TT, Poon RT, Yuen WK et al (2013) Long-term survival analysis of pure laparoscopic versus open hepatectomy for hepatocellular carcinoma in patients with cirrhosis: a single-center experience. Ann Surg 257:506–511

    Article  PubMed  Google Scholar 

  16. Buell JF, Cherqui D, Geller DA et al (2009) The international position on laparoscopic liver surgery: the Louisville statement, 2008. Ann Surg 250:825–830

    Article  PubMed  Google Scholar 

  17. Lin NC, Nitta H, Wakabayashi G (2013) Laparoscopic major hepatectomy: a systematic literature review and comparison of 3 techniques. Ann Surg 257:205–213

    Article  PubMed  Google Scholar 

  18. Yeo D, Mackay S, Martin D (2012) Single-incision laparoscopic cholecystectomy with routine intraoperative cholangiography and common bile duct exploration via the umbilical port. Surg Endosc 26:1122–1127

    Article  PubMed  Google Scholar 

  19. Kimura T, Nakajima K, Wasa M et al (2003) Laparoscopic liver biopsy performed safely in a child with hepatic dysfunction: report of a case. Surg Today 33:712–713

    Article  PubMed  Google Scholar 

  20. Aikawa M, Miyazawa M, Okamoto K et al (2012) Single-port laparoscopic hepatectomy: technique, safety, and feasibility in a clinical case series. Surg Endosc 26:1696–1701

    Article  PubMed  Google Scholar 

  21. 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 

  22. Choi HJ, You YK, Na GH et al (2012) Single-port laparoscopy-assisted donor right hepatectomy in living donor liver transplantation: sensible approach or unnecessary hindrance? Transplant Proc 44:347–352

    Article  PubMed  CAS  Google Scholar 

  23. Aldrighetti L, Ratti F, Catena M et al (2012) Laparoendoscopic single site (LESS) surgery for left-lateral hepatic sectionectomy as an alternative to traditional laparoscopy: case-matched analysis from a single center. Surg Endosc 26:2016–2022

    Article  PubMed  Google Scholar 

  24. Katkhouda N, Mason RJ, Towfigh S, et al (2005) Laparoscopic versus open appendectomy: a prospective randomized double-blind study. Ann Surg 242:439–448; discussion 448–450

  25. Gangl O, Hofer W, Tomaselli F et al (2011) Single incision laparoscopic cholecystectomy (SILC) versus laparoscopic cholecystectomy (LC): a matched pair analysis. Langenbecks Arch Surg 396:819–824

    Article  PubMed  Google Scholar 

  26. Lee WS, Choi ST, Lee JN et al (2013) Single-port laparoscopic appendectomy versus conventional laparoscopic appendectomy: a prospective randomized controlled study. Ann Surg 257:214–218

    Article  PubMed  Google Scholar 

  27. Wu XS, Shi LB, Gu J et al (2013) Single-incision laparoscopic cholecystectomy versus multi-incision laparoscopic cholecystectomy: a meta-analysis of randomized clinical trials. J Laparoendosc Adv Surg Tech A 23:183–191

    Article  PubMed  Google Scholar 

  28. Garg P, Thakur JD, Garg M et al (2012) Single-incision laparoscopic cholecystectomy vs. conventional laparoscopic cholecystectomy: a meta-analysis of randomized controlled trials. J Gastrointest Surg 16:1618–1628

    Article  PubMed  Google Scholar 

  29. Saad S, Strassel V, Sauerland S (2013) Randomized clinical trial of single-port, minilaparoscopic and conventional laparoscopic cholecystectomy. Br J Surg 100:339–349

    Article  PubMed  CAS  Google Scholar 

  30. Trastulli S, Cirocchi R, Desiderio J et al (2013) Systematic review and meta-analysis of randomized clinical trials comparing single-incision versus conventional laparoscopic cholecystectomy. Br J Surg 100:191–208

    Article  PubMed  CAS  Google Scholar 

  31. Mantke R, Wicht S (2010) Single-port liver cyst fenestration combined with single-port laparoscopic cholecystectomy using completely reusable instruments. Surg Laparosc Endosc Percutan Tech 20:e28–e30

    Article  PubMed  Google Scholar 

  32. Gaujoux S, Kingham TP, Jarnagin WR et al (2011) Single-incision laparoscopic liver resection. Surg Endosc 25:1489–1494

    Article  PubMed  Google Scholar 

  33. Mostaedi R, Milosevic Z, Han HS et al (2012) Laparoscopic liver resection: current role and limitations. World J Gastrointest Oncol 4:187–192

    Article  PubMed  PubMed Central  Google Scholar 

  34. Romanelli JR, Roshek TB 3rd, Lynn DC et al (2010) Single-port laparoscopic cholecystectomy: initial experience. Surg Endosc 24:1374–1379

    Article  PubMed  Google Scholar 

Download references

Conflict of interest

Drs. Minggen Hu, Guodong Zhao, Fei Wang, Dabin Xu, and Rong Liu have no conflicts of interest or financial ties to disclose.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Minggen Hu.

Additional information

Minggen Hu and Guodong Zhao contributed equally to this study.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Hu, M., Zhao, G., Wang, F. et al. Single-Port and Multi-Port Laparoscopic Left Lateral Liver Sectionectomy for Treating Benign Liver Diseases: A Prospective, Randomized, Controlled Study. World J Surg 38, 2668–2673 (2014). https://doi.org/10.1007/s00268-014-2610-3

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00268-014-2610-3

Keywords

Navigation