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Surgical Endoscopy
Published in: Surgical Endoscopy 11/2019

01-11-2019 | Dynamic Manuscript

Pure laparoscopic right posterior sectionectomy using the caudate lobe-first approach

Authors: Yuki Homma, Goro Honda, Masanao Kurata, Yusuke Ome, Manami Doi, Jun Yamamoto

Published in: Surgical Endoscopy | Issue 11/2019

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Abstract

Background

In our process of standardizing laparoscopic right-sided anatomical hepatectomy, we found several advantages of the caudate lobe-first approach. We herein describe our standardized procedure of laparoscopic right posterior sectionectomy (Lap-RPS) using this approach.

Methods

Between January 2011 and January 2018, 31 patients underwent pure Lap-RPS in our hospital. The mean patient age was 68 years (range 47–85 years), and the number of male patients was more than that of female patients (64.5%). Of 31 patients, 20 had metastatic liver tumor, 7 had hepatocellular carcinoma, 3 had intrahepatic cholangiocellular carcinoma, and 1 had hemangioma. All 31 patients had Child–Pugh class A liver function. The surgical technique was recorded on video. Cumulative sum (CUSUM) analyses were applied to assess the learning curve.

Results

The mean operative time was 420 min (range 263–639 min), and the mean amount of blood loss was 304 g (range 10–900 g). No procedure was converted to open surgery. Postoperative bleeding, bile leakage, hepatic failure, and mortality did not occur. CUSUM analyses showed a decrease in the operative time and blood loss after using the caudate lobe-first approach.

Conclusion

Our standardized procedure of Lap-RPS using the caudate lobe-first approach is not only feasible but also expected to provide an advantage for laparoscopic anatomical hepatectomy.
Appendix
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Literature
1.
Honda G, Kurata M, Okuda Y, Kobayashi S, Sakamoto K (2013) Totally laparoscopic hepatectomy exposing the major vessels. J Hepatobiliary Pancreat Sci 20:435–440CrossRef
2.
Honda G, Kurata M, Okuda Y, Kobayashi S, Sakamoto K (2014) Totally laparoscopic hepatectomy exposing the vessels around the tumor intended to secure the surgical margin. Surg Endosc 28:1331–1332CrossRef
3.
Okuda Y, Honda G, Kurata M, Kobayashi S, Sakamoto K (2014) Dorsal approach to the middle hepatic vein in laparoscopic left hemihepatectomy. J Am Coll Surg 219:e1-4CrossRef
4.
Honda G, Kurata M, Okuda Y, Kobayashi S, Sakamoto K (2014) Totally laparoscopic anatomical hepatectomy exposing the major hepatic veins from the root side: a case of the right anterior sectorectomy (with video). J Gastrointest Surg 18:1379–1380CrossRef
5.
Okuda Y, Honda G, Kurata M, Kobayashi S, Sakamoto K (2015) A safe and valid procedure for pure laparoscopic partial hepatectomy of the most posterosuperior area: the top of segment 7. J Am Coll Surg 220:e17–e21CrossRef
6.
Okuda Y, Honda G, Kobayashi S, Sakamoto K, Homma Y, Honjo M, Doi M (2018) Intrahepatic Glissonean pedicle approach to segment 7 from the dorsal side during laparoscopic anatomic hepatectomy of the cranial part of the right liver. J Am Coll Surg 226:e1-6CrossRef
7.
Maeda K, Honda G, Kurata M, Homma Y, Doi M, Yamamoto J, Ome Y (2018) Pure laparoscopic right hemihepatectomy using the caudodorsal side approach (with videos). J Hepatobiliary Pancreat Sci 25:335–341CrossRef
8.
Kobayashi S, Honda G, Kurata M, Tadano S, Sakamoto K, Okuda Y, Abe K (2016) An experimental study on the relationship among airway pressure, pneumoperitoneum pressure, and central venous pressure in pure laparoscopic hepatectomy. Ann Surg 263:1159–1163CrossRef
9.
Okuda Y, Honda G, Kurata M, Kobayashi S (2013) A useful and convenient procedure for intermittent vascular occlusion in laparoscopic hepatectomy. Asian J Endosc Surg 6:100–103CrossRef
10.
Wakabayashi G, Cherqui D, Geller DA, Buell JF, Kaneko H, Han HS, Asbun H, O’Rurke N, Tanabe M, Koffron AJ, Tsung A, Soubrane O, Machado MA, Gayet B, Troisi RI, Pessaux P, Van Dam RM, Scatton O, Abu Hilal M, Belli G, Kwon CH, Edwin B, Choi GH, Aldrighetti LA, Cai X, Cleary S, Chen KH, Schon MR, Sugioka A, Tang CN, Herman P, Pekoli J, Xp Chen, Dagher I, Jarnagin W, Yamamoto M, Strong R, Jagannath P, Lo CM, Clavien PA, Kokudo N, Barkun J, Strasberg SM (2015) Recommendations for laparoscopic liver resection, a report from the second international consensus conference held in Morioka. Ann Surg 261:619–629PubMed
11.
Takahara T, Wakabayashi G, Konno H, Gotoh M, Yamaue H, Yanaga K, Fujimoto J, Kaneko H, Unno M, Endo I, Seto Y, Miyata H, Miyazaki M, Yamamoto M (2016) Comparison of laparoscopic major hepatectomy with propensity score matched open cases from the National Clinical Database in Japan. J J Hepatobiliary Pantreat Sci 23:721–734CrossRef
12.
Kawaguchi Y, Fuks D, Kokudo N, Gayet B (2018) Difficulty of laparoscopic liver resection: proposal for a new classification. Ann Surg 267:12–17CrossRef
13.
Sinndigi NN, Abuawwad M, Halls M, Rawashdeh A, Giovinazzo F, Aljaiuossi A, Wicherts D, D’Hondt M, Hilal MA (2017) Laparoscopic right posterior sectionectomy (LRPS): surgical techniques and clinical outcomes. Surg Endosc 32:2525–2532
14.
Cho JY, Han HS, Yoon YS, Cho JY, Lee W (2015) Outcomes of laparoscopic right posterior sectionectomy in patients with hepatocellular carcinoma in the era of laparoscopic surgery. Surgery 158:135–141CrossRef
Metadata
Title
Pure laparoscopic right posterior sectionectomy using the caudate lobe-first approach
Authors
Yuki Homma
Goro Honda
Masanao Kurata
Yusuke Ome
Manami Doi
Jun Yamamoto
Publication date
01-11-2019
Publisher
Springer US
Published in
Surgical Endoscopy / Issue 11/2019
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-019-06877-w

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