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Unaided Laparoscopic Liver Resection by a Novel Method

YoungRok Choi, Ho-Seong Han, Yoo-Seok Yoon, Jae young Cho, Jae Seong Jang, Seong Wook Kwon, Sungho Kim, Jangkyu Choi. Seoul National University Bundang Hospital

Background: Laparoscopic approach has become the standard procedure for many abdominal surgeries. Based on its minimal invasiveness and cosmetic advantages, these minimal access surgery is moving toward reduced size and fewer ports. We introduce reduced port or single incision laparoscopic liver resection with a novel method.

Patients and Methods: Twenty patients underwent unaided laparoscopic liver resection (15 patients with hepatocellular carcinoma, 1 growing teratoma syndrome. 2 biliary stricture with IHD stone, 2 metastatic carcinoma) between June 2015 and May 2016. Laparoscopic liver resection was performed by the operator alone, using a manual laparoscopic scope holder which could make a stable surgical view without limit activity range from a scopist.

Results: Three patients underwent left lateral sectionectomy and patient underwent tumorectomy by 3 ports. Three patients underwent left hemihepatectomy and 13 patients underwent tumorectomy without inflow occlusion by a trans-umbilical single incision. All procedures did not require open conversion and additional port. Median BMI was 25.4 kg/m2 (range 18.3-34.0) and tumor size was 17.5 (10-59) mm. Operation time and estimated blood loss were 112 (20-260) min and 200 (0-700) mL. The patients discharged median 3 (1-9) days after operation. Two patients with postoperative abdominal fluid collection required a percutaneous drainage.

Conclusion: Unaided reduced port or single incision laparoscopic liver resection might decrease a hospital stay. With the risk of bleeding and technical difficulties, candidates should be carefully selected to obtain the benefit from this surgical technique


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

Abstract ID: 78999

Program Number: P465

Presentation Session: Poster (Non CME)

Presentation Type: Poster

31

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