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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 6/2017

01-06-2017 | Hepatobiliary Tumors

Three-Dimensional Laparoscopic Anatomical Segment 8 Liver Resection with Glissonian Approach

Authors: Jae Yool Jang, MD, Ho-Seong Han, MD, PhD, Yoo Seok Yoon, MD, PhD, Jai Young Cho, MD, PhD, YoungRok Choi, MD, Woohyung Lee, MD, Hong Kyung Shin, MD, Han Lim Choi, MD

Published in: Annals of Surgical Oncology | Issue 6/2017

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Abstract

Background

Anatomical liver resection has been reported to have oncologic benefit over nonanatomical resection in surgery for hepatocellular carcinoma (HCC). Basic concept of anatomical resection is preventing tumor spread through the portal or venous flow. Few cases have been reported for laparoscopic anatomical segment 8 resection because of its technical difficulties. This video shows operative techniques for laparoscopic anatomical resection of segment 8, exposing middle and right hepatic vein and inferior vena cava using three-dimensional video.

Methods

A 61-year-old male was diagnosed to be a hepatitis B virus carrier 6 years ago. A 6.6-cm-sized HCC lesion was detected at segment 8 by computed tomography scan. We have used a high-definition, three-dimensional laparoscope with a deflectable tip (Olympus Medical Systems Corp., Japan), a trocar inserted in the right seventh intercostal space to obtain the optimal field of view on the superior-posterior portion of the liver. Using the Glissonian pedicle approach, we isolated and clamped the branch to the segment 8 to confirm the anatomical border of the segment 8. Segmentectomy was completed exposing the middle and right hepatic vein and inferior vena cava.

Results

Operation took 420 min. Estimated blood loss was 600 mL, and no red blood cell was transfused. Final pathology was an HCC with 0.3-cm safety margin. The patient discharged on the sixth day after operation with normal liver function test results. There was no operation-related complication from the operation day to the first outpatient visit day.

Conclusions

Laparoscopic anatomical resection of segment 8 is feasible.
Appendix
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Metadata
Title
Three-Dimensional Laparoscopic Anatomical Segment 8 Liver Resection with Glissonian Approach
Authors
Jae Yool Jang, MD
Ho-Seong Han, MD, PhD
Yoo Seok Yoon, MD, PhD
Jai Young Cho, MD, PhD
YoungRok Choi, MD
Woohyung Lee, MD
Hong Kyung Shin, MD
Han Lim Choi, MD
Publication date
01-06-2017
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue 6/2017
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-017-5778-6

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