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Surgical Endoscopy

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01-08-2018 | Dynamic Manuscript

3D vision and maintenance of stable pneumoperitoneum: a new step in the development of laparoscopic right hepatectomy

Authors: Takayuki Kawai, Claire Goumard, Florence Jeune, Shohei Komatsu, Olivier Soubrane, Olivier Scatton

Published in: Surgical Endoscopy | Issue 8/2018

Abstract

Background

Although laparoscopic liver resection is widely performed, many technical difficulties remain, such as accurate isolation/division of hepatic vessels in laparoscopic right hepatectomy (LRH). Innovative surgical devices, such as three-dimensional (3D) laparoscopy and optimized carbon dioxide (CO₂) insufflation system, may help to overcome technical difficulties in LRH. The purpose of this study was to analyze the efficacy of 3D vision associated with active pneumoperitoneum maintenance in LRH.

Methods

In our prospectively maintained database from 2006, 75 consecutive LRH from May 2011 to June 2017 were included in this study. All LRH were performed with 2D vision and standard CO₂ insufflator (2D-LRH group, 45 cases) or 3D vision with optimized CO₂ insufflator (3D-LRH group, 30 cases). Preoperative clinical characteristics, surgical data including operation time of separate steps within the procedure, and postoperative complications were compared between the two groups.

Results

Clinical and pathological factors were comparable between two groups. Total operative time was significantly shorter in 3D-LRH group than in 2D-LRH (360 vs 390 min, P = 0.029). Right hepatic pedicle dissection time was significantly shorter in 3D-LRH group (101 vs 123 min, P = 0.003). Liver parenchyma transection time was also shorter in 3D-LRH group (138 vs 151 min, P = 0.089), although not significant. There was no significant difference in liver mobilization time, intraoperative bleeding/transfusion, and postoperative complications.

Conclusions

3D vision with maintenance of pneumoperitoneum facilitates hepatic vascular isolation/division, and may contribute to the development of LRH.

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

Wakabayashi G, Cherqui D, Geller DA et al (2015) Recommendations for laparoscopic liver resection: a report from the second international consensus conference held in Morioka. Ann Surg 261:619–629PubMed

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

Buell JF, Thomas MT, Rudich S et al (2008) Experience with more than 500 minimally invasive hepatic procedures. Ann Surg 248:475–486PubMed

Sasaki A, Nitta H, Otsuka K et al (2009) Ten-year experience of totally laparoscopic liver resection in a single institution. Br J Surg 96:274–279CrossRefPubMed

Tranchart H, Di Giuro G, Lainas P et al (2010) Laparoscopic resection for hepatocellular carcinoma: a matched-pair comparative study. Surg Endosc 24:1170–1176CrossRefPubMed

Beppu T, Wakabayashi G, Hasegawa K et al (2015) Long-term and perioperative outcomes of laparoscopic versus open liver resection for colorectal liver metastases with propensity score matching: a multi-institutional Japanese study. J Hepatobiliary Pancreat Sci 22:711–720CrossRefPubMed

Ciria R, Cherqui D, Geller DA et al (2016) Comparative short-term benefits of laparoscopic liver resection: 9000 cases and climbing. Ann Surg 263:761–777CrossRefPubMed

Dagher I, Gayet B, Tzanis D et al (2014) International experience for laparoscopic major liver resection. J Hepatobiliary Pancreat Sci 21:732–736CrossRefPubMed

10.

Nomi T, Fuks D, Govindasamy M et al (2015) Risk factors for complications after laparoscopic major hepatectomy. Br J Surg 102:254–260CrossRefPubMed

11.

Kluger MD, Vigano L, Barroso R et al (2013) The learning curve in laparoscopic major liver resection. J Hepatobiliary Pancreat Sci 20:131–136CrossRefPubMed

12.

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

13.

Soubrane O, Schwarz L, Cauchy F et al (2015) A conceptual technique for laparoscopic right hepatectomy based on facts and oncologic principles: the Caudal approach. Ann Surg 261:1226–1231CrossRefPubMed

14.

Komatsu S, Scatton O, Goumard C et al (2017) Development process and technical aspects of laparoscopic hepatectomy: learning curve based on 15 years of experience. J Am Coll Surg 224:841–850CrossRefPubMed

15.

Fergo C, Burcharth J, Pommergaard HC et al (2017) Three-dimensional laparoscopy vs 2-dimensional laparoscopy with high-definition technology for abdominal surgery: a systematic review. Am J Surg 213:159–170CrossRefPubMed

16.

Sørensen SM, Savran MM, Konge L et al (2016) Three-dimensional versus two-dimensional vision in laparoscopy: a systematic review. Surg Endosc 30:11–23CrossRefPubMed

17.

Usta TA, Ozkaynak A, Kovalak E et al (2015) An assessment of the new generation three-dimensional high definition laparoscopic vision system on surgical skills: a randomized prospective study. Surg Endosc 29:2305–2313CrossRefPubMed

18.

Currò G, La Malfa G, Caizzone A et al (2015) Three-dimensional (3D) versus two-dimensional (2D) laparoscopic bariatric surgery: a single-surgeon prospective randomized comparative study. Obes Surg 25:2120–2124CrossRefPubMed

19.

Mashiach R, Mezhybovsky V, Nevler A et al (2014) Three-dimensional imaging improves surgical skill performance in a laparoscopic test model for both experienced and novice laparoscopic surgeons. Surg Endosc 28:3489–3493CrossRefPubMed

20.

Smith R, Schwab K, Day A et al (2014) Effect of passive polarizing three-dimensional displays on surgical performance for experienced laparoscopic surgeons. Br J Surg 101:1453–1459CrossRefPubMed

21.

Luketina RR, Knauer M, Köhler G et al (2014) Comparison of a standard CO₂ pressure pneumoperitoneum insufflator versus AirSeal: study protocol of a randomized controlled trial. Trials 15:239CrossRefPubMedPubMedCentral

22.

Dindo D, Demartines N, Clavien PA (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 240:205–213CrossRefPubMedPubMedCentral

23.

Balzan S, Belghiti J, Farges O et al (2005) The “50–50 criteria” on postoperative day 5: an accurate predictor of liver failure and death after hepatectomy. Ann Surg 242:824–828 (discussion 828–829)CrossRefPubMedPubMedCentral

24.

Cherqui D, Husson E, Hammoud R et al (2000) Laparoscopic liver resections: a feasibility study in 30 patients. Ann Surg 232:753–762CrossRefPubMedPubMedCentral

25.

Descottes B, Glineur D, Lachachi F et al (2003) Laparoscopic liver resection of benign liver tumors. Surg Endosc 17:23–30CrossRefPubMed

26.

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

27.

Scatton O, Katsanos G, Boillot O et al (2015) Pure laparoscopic left lateral sectionectomy in living donors: from innovation to development in France. Ann Surg 261:506–512CrossRefPubMed

28.

Komatsu S, Brustia R, Goumard C et al (2016) Laparoscopic versus open major hepatectomy for hepatocellular carcinoma: a matched pair analysis. Surg Endosc 30:1965–1974CrossRefPubMed

29.

Goumard C, Komatsu S, Brustia R et al (2017) Technical feasibility and safety of laparoscopic right hepatectomy for hepatocellular carcinoma following sequential TACE-PVE: a comparative study. Surg Endosc 31:2340–2349CrossRefPubMed

30.

Cauchy F, Fuks D, Nomi T et al (2016) Benefits of laparoscopy in elderly patients requiring major liver resection. J Am Coll Surg 222:174–184.e110CrossRefPubMed

31.

Fuks D, Cauchy F, Ftériche S et al (2016) Laparoscopy decreases pulmonary complications in patients undergoing major liver resection: a propensity score analysis. Ann Surg 263:353–361CrossRefPubMed

32.

Kong SH, Oh BM, Yoon H et al (2010) Comparison of two- and three-dimensional camera systems in laparoscopic performance: a novel 3D system with one camera. Surg Endosc 24:1132–1143CrossRefPubMed

33.

Martínez-Ubieto F, Jiménez-Bernadó T, Martínez-Ubieto J et al (2015) Three-dimensional laparoscopic sleeve gastrectomy: improved patient safety and surgeon convenience. Int Surg 100:1134–1137CrossRefPubMedPubMedCentral

34.

Velayutham V, Fuks D, Nomi T et al (2016) 3D visualization reduces operating time when compared to high-definition 2D in laparoscopic liver resection: a case-matched study. Surg Endosc 30:147–153CrossRefPubMed

Title: 3D vision and maintenance of stable pneumoperitoneum: a new step in the development of laparoscopic right hepatectomy
Authors: Takayuki Kawai
Claire Goumard
Florence Jeune
Shohei Komatsu
Olivier Soubrane
Olivier Scatton
Publication date: 01-08-2018
Publisher: Springer US
Published in: Surgical Endoscopy / Issue 8/2018
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-018-6205-1

At a glance: The STEP trials

Springer Medicine

3D vision and maintenance of stable pneumoperitoneum: a new step in the development of laparoscopic right hepatectomy

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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