Transumbilical single-incision laparoscopic hepatectomy using precoagulation and clipless technique in a patient with combined hepatocellular-cholangiocarcinoma: a case report

Surg Laparosc Endosc Percutan Tech. 2013 Oct;23(5):e194-9. doi: 10.1097/SLE.0b013e31828b8602.

Abstract

We report our first case of single-incision laparoscopic hepatectomy in a 43-year-old woman with a 30-mm solitary combined hepatocellular-cholangiocarcinoma. A port of single-incision laparoscopic surgery was inserted through the abdominal wall using a 2.5-cm single incision in the umbilical area. To obtain adequate operative view for the tumor in segment 6, a 5-mm flexible endoscope, roticulated instruments, and a miniloop retractor were used. After precoagulation with a 5-mm flexible microwave probe, liver resection was performed using laparoscopic ultrasonic shears, soft-coagulation devices, and a tissue-sealing knife. Subsequently, cholecystectomy was carried out for a gallbladder polyp. The procedure was successfully completed without conversion to conventional laparoscopic technique. The operation time was 180 minutes and operative blood loss was uncountable. Transumbilical single-incision laparoscopic hepatectomy using precoagulation and clipless techniques is feasible and seems to provide better cosmetic appearance in selected cases by qualified endoscopic liver surgeons.

Publication types

  • Case Reports
  • Technical Report

MeSH terms

  • Adult
  • Bile Duct Neoplasms / complications
  • Bile Duct Neoplasms / surgery*
  • Bile Ducts, Intrahepatic / surgery*
  • Carcinoma, Hepatocellular / complications
  • Carcinoma, Hepatocellular / surgery*
  • Cholangiocarcinoma / complications
  • Cholangiocarcinoma / surgery*
  • Female
  • Hepatectomy / methods*
  • Humans
  • Intraoperative Care / methods
  • Laparoscopy / methods
  • Light Coagulation / methods
  • Liver Neoplasms / complications
  • Liver Neoplasms / surgery*
  • Male
  • Operative Time