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Single-Incision Laparoscopic Right Posterior Sectionectomy by Extraglissonian Approach for Hepatocellular Carcinoma: A Case Report

Shu-Hung Chuang, MD, PhD1,2, Hon-Phin Wong, MD1,2, Min-Chang Hung, MD1,2, Shin-Wei Huang, MD1,2, Dev-Aur Chou, MD1,2, Hurng-Sheng Wu, MD1,2. 1IRCAD-AITS Show Chwan Health Care System, Changhua, Taiwan, 2Division of General Surgery, Department of Surgery, Show Chwan Memorial Hospital, Changhua, Taiwan

INTRODUCTION: Single-incision laparoscopic surgery or laparoendoscopic single-site surgery is emerging as an alternative to conventional multiple-incision laparoscopic surgery in recent two decades. The existing documentation of applying this novel technique to laparoscopic hepatectomy, one of the most complicated and demanding procedures, is limited to a few small series.

METHODS AND PROCEDURES: A 59 y/o female patient was diagnosed as having a 3.7 cm hepatocellular carcinoma (HCC) at the junction of S6 and S7 by magnetic resonance imaging. Single-incision laparoscopic hepatectomy and cholecystectomy with single-incision multiple-port longitudinal-array (SIMPLY) technique was performed. We controlled the hepatic inflow by extraglissonian approach following cholecystectomy. The liver parenchyma was dissected by a harmonic scalpel with clamp-crush technique; the major vessels and bile ducts were divided by linear staplers. The operative time was 559 mins and the estimated blood loss was 800 ml. The pathologic report showed a 3.5×3.5×3.3 cm moderately differentiated HCC with a closest margin of 3 mm. She was discharged on the 6th postoperative day uneventfully.

CONCLUSION: Single-incision laparoscopic hepatectomy with SIMPLY technique and extraglissonian approach is feasible and safe for right posterior sectionectomy. We anticipate applying this technique to other major liver resections in the future.


Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 78930

Program Number: P476

Presentation Session: Poster (Non CME)

Presentation Type: Poster

46

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