Shu-Hung Chuang, MD, PhD, Dev-Aur Chou, MD, Shih-Wei Huang, MD, Min-Chang Hung, MD, Jimmy Chunmin Su, MD, Hurng-Sheng Wu, MD. 1. Division of General Surgery, Department of Surgery, Show Chwan Memorial Hospital, Changhua, Taiwan 2. IRCAD-AITS Show Chwan Health Care System, Changhua, Taiwan
INTRODUCTION: Single-incision laparoscopic hepatectomy (SILH) has been showed feasible and safe in experienced hands for selected patients with benign or malignant liver diseases. There were only small series reported and most of the procedures were minor liver resections. We herein present our experience of SILH during a period of 13 months.
METHODS AND PROCEDURES: Consecutive 13 patients underwent SILH which were performed by two experienced laparoscopic surgeons with straight instruments. Patient characteristics and surgical outcomes were analyzed by reviewing the medical charts.
RESULTS: The patient age was 62.7 ± 9.2 (47-78) years with male predominance (8 patients, 61.5 %). Six patients (46.2 %) had liver cirrhosis proved by pathologic examinations. Nine procedures (69.2 %) were indicated for malignancy. Four major hepatectomies (over two segments) and nine minor ones were performed including seven anatomical resections. The abdominal incisions were para- or trans-umbilical except one which was along the old operative scar at lower midline, while most of them (n=12, 92.3 %) was within 5 cm in length. Inflow control was carried out by either individual hilar dissection or extraglissonian approach instead of Pringle maneuver. The operations were all accomplished successfully without additional ports or open conversion. The operative time was 436.5 ± 178.4 (163-673) min and the estimated blood loss was 435.0 ± 377.2 (75-1400) mL. Five (38.5 %) patients encountered complications and four of them were classified as Clavien-Dindo grade I. The postoperative length of hospital stay was 6.1 ± 2.2 (4-10) days. There was no mortality.
CONCLUSION: SILH can be performed safely and efficaciously for selected patients with benign and malignant liver diseases including cirrhosis. Not only minor but also major liver resections are feasible. This innovative procedure provides low postoperative pain and fast recovery. Before adopting this demanding technique, surgeons should be familiar with both single-incision laparoscopic surgery and laparoscopic hepatectomy. Better outcomes after the learning curve could be anticipated.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 87635
Program Number: P529
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster
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