Abstract
Many studies have recently reported on laparoscopic liver resection, although its development has been slow compared to laparoscopy in other fields. The indications for the location of laparoscopic liver resection have previously been limited to easily accessible lesions. Performing laparoscopic liver resection in the posterior and superior parts of the liver has been considered difficult due to inadequate exposure, the poor operative field and the difficulty with parenchymal dissection. Flexible endoscopy, high definition imaging and various kinds of equipment for parenchymal transection have been introduced for clinical use. In addition, much experience with this procedure has been accumulated at many centers. Accordingly, there are an increasing number of reports on laparoscopic liver resection in difficult locations. At our institution, the location of the tumor is no longer a limitation to laparoscopic liver resection. However, for safer laparoscopic liver resection, the patient positioning and trocar placement should be individualized according to the tumor location. The type of resection also may depend on the remaining liver’s functional capacity. We describe here the technical considerations for performing laparoscopic liver resection, including the technical considerations for performing laparoscopic liver resection for lesions located in the postero-superior segments of the liver.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Buell JF, Thomas MJ, Doty TC, Gersin KS, Merchen TD, Gupta M, et al. An initial experience and evolution of laparoscopic hepatic resectional surgery. Surgery. 2004;136:804–11.
Morino M, Morra I, Rosso E, Miglietta C, Garrone C. Laparoscopic vs open hepatic resection: a comparative study. Surg Endosc. 2003;17:1914–8.
Vibert E, Perniceni T, Levard H, Denet C, Shahri NK, Gayet B. Laparoscopic liver resection. Br J Surg. 2006;93:67–72.
John TG, Greig JD, Crosbie JL, Miles WF, Garden OJ. Superior staging of liver tumors with laparoscopy and laparoscopic ultrasound. Ann Surg. 1994;220:711–9.
Rahusen FD, Cuesta MA, Borgstein PJ, Bleichrodt RP, Barkhof F, Doesburg T, et al. Selection of patients for resection of colorectal metastases to the liver using diagnostic laparoscopy and laparoscopic ultrasonography. Ann Surg. 1999;230:31–7.
Cherqui D, Husson E, Hammoud R, Malassagne B, Stephan F, Bensaid S, et al. Laparoscopic liver resections: a feasibility study in 30 patients. Ann Surg. 2000;232:753–62.
Gigot JF, Glineur D, Santiago Azagra J, Goergen M, Ceuterick M, Morino M, et al. Laparoscopic liver resection for malignant liver tumors: preliminary results of a multicenter European study. Ann Surg. 2002;236:90–7.
Kaneko H, Takagi S, Shiba T. Laparoscopic partial hepatectomy and left lateral segmentectomy: technique and results of a clinical series. Surgery. 1996;120:468–75.
Dulucq JL, Wintringer P, Stabilini C, Berticelli J, Mahajna A. Laparoscopic liver resections: a single center experience. Surg Endosc. 2005;19:886–91.
Laurent A, Cherqui D, Lesurtel M, Brunetti F, Tayar C, Fagniez PL. Laparoscopic liver resection for subcapsular hepatocellular carcinoma complicating chronic liver disease. Arch Surg. 2003;138:763–9 (discussion 769).
Cho JY, Han HS, Yoon YS, Shin SH. Experiences of laparoscopic liver resection including lesions in the posterosuperior segments of the liver. Surg Endosc. 2008;22:2344–9.
Cho JY, Han HS, Yoon YS, Shin SH. Feasibility of laparoscopic liver resection for tumors located in the posterosuperior segments of the liver, with a special reference to overcoming current limitations on tumor location. Surgery. 2008;144:32–8.
Yoon YS, Han HS, Shin SH, Cho JY, Min SK, Lee HK. Laparoscopic treatment for intrahepatic duct stones in the era of laparoscopy: laparoscopic intrahepatic duct exploration and laparoscopic hepatectomy. Ann Surg. 2009;249:286–91.
Cherqui D. Laparoscopic liver resection. Br J Surg. 2003;90:644–6.
Kim CG, Yoon YS, Han HS, Shin SH, Chun KS, Jang JY, et al. Experience of total laparoscopic hepatectomy. J Korean Surg Soc. 2007;73:490–5.
Yoon YS, Han HS, Shin SH, Cho JY, Chun KS, Jang JY, et al. Total laparoscopic liver resection for a metastatic lesion located in the caudate lobe. J Korean Surg Soc. 2007;73:303–4.
Yoon YS, Han HS, Choi YS, Jang JY, Suh KS, Kim SW, et al. Total laparoscopic right posterior sectionectomy for hepatocellular carcinoma. J Laparoendosc Adv Surg Tech A. 2006;16:274–7.
Yoon YS, Han HS, Choi YS, Lee SI, Jang JY, Suh KS, et al. Total laparoscopic left lateral sectionectomy performed in a child with benign liver mass. J Pediatr Surg. 2006;41:e25–8.
Kim SH, Park SJ, Lee SA, Lee WJ, Park JW, Kim CM. Isolated caudate lobectomy using the hanging maneuver. Surgery. 2006;139:847–50.
Dulucq JL, Wintringer P, Stabilini C, Mahajna A. Isolated laparoscopic resection of the hepatic caudate lobe: surgical technique and a report of 2 cases. Surg Laparosc Endosc Percutan Tech. 2006;16:32–5.
Chang S, Laurent A, Tayar C, Karoui M, Cherqui D. Laparoscopy as a routine approach for left lateral sectionectomy. Br J Surg. 2007;94:58–63.
Teramoto K, Kawamura T, Takamatsu S, Noguchi N, Nakamura N, Arii S. Laparoscopic and thoracoscopic partial hepatectomy for hepatocellular carcinoma. World J Surg. 2003;27:1131–6.
Dagher I, Proske JM, Carloni A, Richa H, Tranchart H, Franco D. Laparoscopic liver resection: results for 70 patients. Surg Endosc. 2007;21:619–24.
Maehara S, Adachi E, Shimada M, Taketomi A, Shirabe K, Tanaka S, et al. Clinical usefulness of biliary scope for Pringle’s maneuver in laparoscopic hepatectomy. J Am Coll Surg. 2007;205:816–8.
Conflict of interest statement
Nothing to declare.
Author information
Authors and Affiliations
Corresponding author
About this article
Cite this article
Han, HS., Cho, J.Y. & Yoon, YS. Techniques for performing laparoscopic liver resection in various hepatic locations. J Hepatobiliary Pancreat Surg 16, 427–432 (2009). https://doi.org/10.1007/s00534-009-0118-2
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00534-009-0118-2