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Journal of Hepato-Biliary-Pancreatic Sciences

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01-11-2009 | Surgeon at work

Laparoscopic hand-assisted right hemihepatectomy by ultrasound-directed intrahepatic approach

Authors: Giulio Belli, Alberto D’Agostino, Corrado Fantini, Andrea Belli, Luigi Cioffi, Paolo Limongelli, Gianluca Russo

Published in: Journal of Hepato-Biliary-Pancreatic Sciences | Issue 6/2009

Abstract

Background/purpose

Laparoscopic hepatectomy is a promising option for patients affected by a liver mass, and the procedure is gaining popularity. Minor laparoscopic resections have been widely reported. In contrast, major laparoscopic hepatectomy has been performed in only a limited number of cases. Hand-assisted laparoscopic liver surgery has been advocated in order to improve liver exposure and vascular control and increase the safety of the procedure. Transparenchymal en-bloc transection of the right portal triad has been reported to be safe and useful in open surgery.

Methods

We describe a personal technique for hand-assisted right hemihepatectomy. With ultrasound guidance, the right hepatic pedicle is isolated intrahepatically and transected en bloc with a single firing of an endostapler. Parenchymal transection is carried out with ultrasonically activated or vessel-sealing devices together with endostaplers.

Results

The procedure was successfully accomplished in three patients. The Pringle maneuver was never performed. No intraoperative or postoperative complications occurred.

Conclusion

This study is the first to report a technique of right hemihepatectomy that combines hand-assisted laparoscopy and an ultrasound-guided intrahepatic approach. This technique may be a useful option to simplify the operation, reduce operative time, and increase the safety of the procedure.

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Title: Laparoscopic hand-assisted right hemihepatectomy by ultrasound-directed intrahepatic approach
Authors: Giulio Belli
Alberto D’Agostino
Corrado Fantini
Andrea Belli
Luigi Cioffi
Paolo Limongelli
Gianluca Russo
Publication date: 01-11-2009
Publisher: Springer Japan
Published in: Journal of Hepato-Biliary-Pancreatic Sciences / Issue 6/2009
Print ISSN: 1868-6974
Electronic ISSN: 1868-6982
DOI: https://doi.org/10.1007/s00534-009-0156-9

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Laparoscopic hand-assisted right hemihepatectomy by ultrasound-directed intrahepatic approach

Abstract

Background/purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background/purpose

Methods

Results

Conclusion

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