Single-port laparoscopic hepatectomy: technique, safety, and feasibility in a clinical case series

Surg Endosc. 2012 Jun;26(6):1696-701. doi: 10.1007/s00464-011-2095-1. Epub 2011 Dec 18.

Abstract

Background: The recent use of single-port-access surgery in cholecystectomy and other abdominal surgeries has confirmed its safety and validity as a treatment option. However, few reports have described the use of complete single-port access surgeries in hepatectomy for neoplasms.

Methods: The authors performed single-port laparoscopic hepatectomy (SLH) for eight patients (5 patients with hepatocellular carcinoma, 1 patient with metastatic liver tumor, 1 patient with endocrine liver tumor, and 1 patient with hemangioma). Furthermore, in terms of Child-Pugh classification, five patients were in category A, two in category B, and one in category C. The patients were eligible for SLH if they had solitary tumors measuring 3 cm or smaller on the caudal surface of the liver. The lesion was approached through a 20-mm supraumbilical incision using a single-port access device.

Results: No patient experienced intraoperative complications that required additional port access and conversion to laparotomy. The operative time was 148 min (range, 141-235 min). The postoperative course of the patients was uneventful, and they were discharged an average of 6.2 days (range, 3-11 days) after the operation. Approximately 2 weeks after discharge, the patients experienced no wound pain or liver dysfunction.

Conclusion: The SLH technique is a safe and feasible procedure for a specific group of candidates, including patients with high-grade liver dysfunction.

Publication types

  • Evaluation Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Equipment Design
  • Feasibility Studies
  • Female
  • Hepatectomy / instrumentation
  • Hepatectomy / methods*
  • Humans
  • Laparoscopy / methods*
  • Liver Neoplasms / pathology
  • Liver Neoplasms / surgery*
  • Male
  • Middle Aged
  • Surgical Instruments
  • Treatment Outcome