Laparoscopic surgery using vessel sealing system for giant liver cysts

Mami Kanamoto, Mitsuo Shimada, Tohru Utsunomiya, Yuji Morine, Satoru Imura, Tetsuya Ikemoto, Hiroki Mori, Yusuke Arakawa, Syuichi Iwahashi, Shinichiro Yamara, Masahito Asanoma, Daichi Ishikawa

Department of Surgery, The University of Tokushima

Background: Cases of liver cyst with symptoms, such as jaundice, abdominal pain, and intracystic infection, do required treatment. In laparoscopic deroofing of liver cyst, appropriate treatments are needed in the cases with cystic walls containing vessels or bile ducts. On the other hands, Liga Sure (Vessel sealing system: VSS) can seal not only vessels, but also bile duct very well. We experienced 3 cases to be performed deroofing of liver cyst by using of VSS.

Cases: (Case1) A 70’s woman visited our hospital because of abdominal pressure symptom. Abdominal computed tomography showed some liver cysts and 13cm diameter in maximum. Laparoscopic deroofing was performed with Liga Sure IMPACT. After then, we made a small incision and performed partial hepatectomy. Operation time was 4 hours and 28 minutes, and blood loss was 82 ml. (Case2) A 50’s woman visited our hospital because of abdominal tumor and abdominal discomfort. Abdominal computer tomography showed a liver cyst 15cm in diameter in hepatic right lobe. We performed single incision laparoscopic deroofing by using Liga Sure Blunt tip. Operation time was 1 hour and 33 minutes, there was no blood loss. She was discharged 10 days after surgery. (Case3) An 80’s man visited our hospital because of abdominal pain. Abdominal computed tomography showed a huge liver cyst 25cm in diameter in hepatic right lobe. We tried to deroof by using Liga Sure Blunt tip under single incision laparoscopic surgery. Unfortunately we have to add one more port because the wall of liver cyst was too thick to be held with a 3mm diameter forceps. Operation time was 2 hours and 43 minutes, blood loss was 10 ml. He was discharged 7 days after surgery. All cases showed no bleeding or bile leakage after surgery. And more, all cases showed recurrence.

Conclusions: A Laparoscopic deroofing using of VSS can be a noninvasive and safe treatment for liver cyst because VSS can seal not only vessels but also bile duct very well.

Session: Poster Presentation

Program Number: P525