Laparoscopic liver right posterior sectionectomies; surgical technique and clinical results of a single surgeon experience Laparoskopik karaciğer sağ arka kesitektomiler; tek cerrah deneyiminin cerrahi tekniği ve klinik sonuçları


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Öztaş M., Lapsekili E., Can M. F.

Turkish Journal of Surgery, vol.38, no.1, pp.18-24, 2022 (Scopus) identifier identifier

  • Publication Type: Article / Article
  • Volume: 38 Issue: 1
  • Publication Date: 2022
  • Doi Number: 10.47717/turkjsurg.2022.5623
  • Journal Name: Turkish Journal of Surgery
  • Journal Indexes: Scopus, Academic Search Premier
  • Page Numbers: pp.18-24
  • Keywords: Hepatobiliary surgery, Laparoscopic, Liver resection, Right posterior, Sectionectomy, Techniques
  • Lokman Hekim University Affiliated: Yes

Abstract

© Copyright 2022 by Turkish Surgical SocietyObjective: Laparoscopic liver resections have been performed with increasing frequency in recent years. With increasing surgical experience and technological developments, more complex laparoscopic liver resections can now be applied. Laparoscopic right posterior sectionectomy (LSPS) requires a sophisticated and highly challenging surgical technique due to the length of the parenchyma transection line and the camera out of view in laparoscopic surgery. The aim of this study was to share tips and tricks about resection which will contribute to the operation time and technique. Material and Methods: Evaluation was made of the laparoscopic major liver resections performed consecutively between 2015-2020 in our center. During the resections, three different inflow control techniques were used; hilar, glassonian and intraparenchymal approach. Results: A total of 14 LSPS surgeries were performed. Mean age of the patients was 51.6 ± 10.2 years (34-68), and mean operation time was 300 ± 58 (200-440) minutes. The Pringle maneuver was applied to all patients, with a mean time of 58.4 ± 14.4 (30-75) minutes. Mean perioperative bleeding was measured as 290 ± 105 (140-550) mL. Additional surgery was performed on six patients in the same session. Complications occurred in three patients. No perioperative mortality was observed. Conclusion: LSPS is a technically difficult process, which requires advanced skills in both liver surgery and laparoscopic surgery. Surgeons should consider applying this method, which offers different advantages depending on the location and nature of the lesion, after completing the learning curve by performing laparoscopic liver surgery of the correct number and type. In our article, we stated the tips and tricks that make it easy to perform laparoscopic right posterior sectionectomies, which have been thought to be difficult until recently and these difficulties have been clearly stated in many articles.