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01-06-2018 | Hepatobiliary Tumors

Tips and Tricks for a Laparoscopic Approach to Paracaval Liver Segments

Authors: G. Fiorentini, MD, F. Ratti, MD, F. Cipriani, MD, M. Catena, MD, PhD, M. Paganelli, MD, L. Aldrighetti, MD, PhD

Published in: Annals of Surgical Oncology | Issue 6/2018

Abstract

Background

A dramatic spread of laparoscopic liver surgery has been experienced over the last years. The approach to paracaval liver segments 1 and 9 is still poorly described in literature, mainly due to its technical demands.

Objective

The aim of this article was to introduce a safe and effective approach to paracaval liver segments through laparoscopy.

Methods

A minimally invasive approach to resection of Segments 1 and 9 is presented, and an operative set-up is depicted. A step-by-step technique describing the inferior vena cava (IVC) with left and right hepatic venous junction exposure, segmental pedicle isolation, and parenchymal transection is shown through a video document.

Results

Postoperative courses were uneventful, and patients were discharged on postoperative day 3.

Discussion

The approach to paracaval liver segments requires accurate preoperative case selection, technical, surgical, and anesthesiological expertise in laparoscopic liver surgery, and adequate instrumentary.

Conclusion

Paracaval segments of the liver can be approached safely through laparoscopy by teams with extensive expertise in the field of laparoscopic liver surgery; however, suspected malignant infiltration of the IVC or unclear preoperative anatomy still contraindicate this approach.

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Title: Tips and Tricks for a Laparoscopic Approach to Paracaval Liver Segments
Authors: G. Fiorentini, MD
F. Ratti, MD
F. Cipriani, MD
M. Catena, MD, PhD
M. Paganelli, MD
L. Aldrighetti, MD, PhD
Publication date: 01-06-2018
Publisher: Springer International Publishing
Published in: Annals of Surgical Oncology / Issue 6/2018
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI: https://doi.org/10.1245/s10434-018-6432-7

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Tips and Tricks for a Laparoscopic Approach to Paracaval Liver Segments

Abstract

Background

Objective

Methods

Results

Discussion

Conclusion

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Objective

Methods

Results

Discussion

Conclusion

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