Laparoscopic right posterior sectionectomy: single-center experience and technical aspects

Langenbecks Arch Surg. 2019 Feb;404(1):21-29. doi: 10.1007/s00423-018-1731-9. Epub 2018 Nov 21.

Abstract

Purpose: Laparoscopic right posterior sectionectomy (LRPS) is a technically demanding procedure. The aim of this article is to share our experience with LRPS and to highlight technical aspects of this procedure.

Methods: This is a single-center retrospective analysis of all patients who underwent LRPS between September 2011 and October 2017. Data were retrieved from a prospectively maintained database. Video-in-picture (VIP) technology is used to facilitate and to highlight the technical aspects of this procedure.

Results: In total, 18 patients underwent LRPS. Indication for surgery was mainly liver metastases (n = 11) and hepatocellular carcinoma (n = 6). The Glissonean approach for inflow control was used in 13 patients. Median operative time was 162 (140-190) minutes. Median blood loss was 325 mL (IQR: 150-450). One conversion (5.5%) was required. There were two minor complications and one major complication. Median hospital stay was 6 days (range 5-8 days). All patients had an R0 resection. There was no 90-day mortality.

Conclusion: The results of our experience in LRPS add weight to the feasibility and safety of this approach.

Keywords: Glissonean approach; Hepatobiliary surgery; Laparoscopy; Posterosuperior segments; Techniques.

MeSH terms

  • Adult
  • Aged
  • Blood Loss, Surgical*
  • Carcinoma, Hepatocellular / pathology
  • Carcinoma, Hepatocellular / surgery
  • Feasibility Studies
  • Female
  • Hepatectomy / adverse effects
  • Hepatectomy / methods*
  • Humans
  • Laparoscopy / adverse effects
  • Laparoscopy / methods*
  • Length of Stay
  • Liver Neoplasms / pathology
  • Liver Neoplasms / surgery*
  • Male
  • Middle Aged
  • Operative Time
  • Patient Positioning*
  • Postoperative Complications / epidemiology*
  • Retrospective Studies