Dandan Hu, Jiancong Chen, Zhongguo Zhou, Minshan Chen, Yaojun Zhang. Sun Yat-Sen University Cancer Center
A 49-year-old male patient was clinically diagnosed with primary liver cancer. His 61mm intrahepatic lesion was located in Segment IV, and his serum AFP concentration was 3.86 ng/ml, and PIVKA-II level was 101mAU/ml. After careful preoperative evaluation of this patient, we planned to apply single-port laparoscopic left hepatectomy for him. A simplified single-port device was made at the beginning of the surgical procedure: suture a size 6.5 sterile glove with a 70-70 disposable incision protective sleeve; 4/5 fingers of the glove were respectively connected to a regular trocar; the incision protective sleeve was then placed into the 3 cm paraumbilical vertical incision; pneumoperitoneum was built; and another auxiliary 12 mm trocar was placed 3 cm inferior to the costal margin along the right midclavicular line. The step-by-step surgical procedure was listed below: 1) Dissect the ligamentum teres hepatis and falciform ligament, explore of the size and location of the intrahepatic lesion with intraoperative laparoscopic ultrasound; 2) Resect the gull bladder; 3) Dissect the primary hepatic portal, ligate and cut the left hepatic artery, ligate the left portal vein with silk thread; 4) Dissect the liver parenchyma with ultrasound knife along the ischemic line, special attention should be paid when dealing with the branches of the middle hepatic vein; 5) Use an endo-GIA stapler to ligate and split the left hepatic pedicle and left hepatic vein, and specimen was then removed; 6) Bipolar coagulation forceps was used to control the bleeding of the surgical plane, and a drainage tube was placed in the right subphrenic space, and the specimen was taken out from the abdomen. Total surgical duration was 150 minutes with 300 ml blood loss. No complication was reported and the patient was dismissed from hospital 6 days after the procedure.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 92240
Program Number: V196
Presentation Session: Video Loop Day 1
Presentation Type: VideoLoop