Extracorporeal Pringle Maneuver During Laparoscopic and Robotic Hepatectomy: Detailed Technique and First Comparison with Intracorporeal Maneuver

2018 ◽  
Vol 226 (5) ◽  
pp. e19-e25 ◽  
Author(s):  
Chetana Lim ◽  
Michael Osseis ◽  
Eylon Lahat ◽  
Daniel Azoulay ◽  
Chady Salloum
HPB ◽  
2020 ◽  
Vol 22 ◽  
pp. S186-S187
Author(s):  
J. Hawksworth ◽  
N.P. Llore ◽  
M.L. Holzner ◽  
P. Radkani ◽  
E. Mesler ◽  
...  

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
F. G. M. Poch ◽  
C. A. Neizert ◽  
B. Geyer ◽  
O. Gemeinhardt ◽  
S. M. Niehues ◽  
...  

AbstractMultibipolar radiofrequency ablation (RFA) is an advanced ablation technique for early stage hepatocellular carcinoma and liver metastases. Vessel cooling in multibipolar RFA has not been systematically investigated. The objective of this study was to evaluate the presence of perivascular vital cells within the ablation zone after multibipolar RFA. Multibipolar RFA were performed in domestic pigs in vivo. Three internally cooled bipolar RFA applicators were used simultaneously. Three experimental settings were planned: (1) inter-applicator-distance: 15 mm; (2) inter-applicator-distance: 20 mm; (3) inter-applicator-distance: 20 mm with hepatic inflow occlusion (Pringle maneuver). A vitality staining was used to analyze liver cell vitality around all vessels in the ablation center with a diameter > 0.5 mm histologically. 771 vessels were identified. No vital tissue was seen around 423 out of 429 vessels (98.6%) situated within the central white zone. Vital cells could be observed around major hepatic vessels situated adjacent to the ablation center. Vessel diameter (> 3.0 mm; p < 0.05) and low vessel-to-ablation-center distance (< 0.2 mm; p < 0.05) were identified as risk factors for incomplete ablation adjacent to hepatic vessels. The vast majority of vessels, which were localized in the clinically relevant white zone, showed no vital perivascular cells, regardless of vessel diameter and vessel type. However, there was a risk of incomplete ablation around major hepatic vessels situated directly within the ablation center. A Pringle maneuver could avoid incomplete ablations.


Author(s):  
Aryan Modasi ◽  
Iswanto Sucandy ◽  
Sharona Ross ◽  
Emily Krill ◽  
Miguel Castro ◽  
...  
Keyword(s):  

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Shaohe Wang ◽  
Yang Yue ◽  
Wenjie Zhang ◽  
Qiaoyu Liu ◽  
Beicheng Sun ◽  
...  

Abstract Background Laparoscopic anatomic hepatectomy (LAH) has gradually become a routine surgical procedure. However, how to expose the whole hepatic vein and avoid the hepatic vein laceration is still a challenge because of the caudate lobe, particularly in right hepatectomy. We adopted a dorsal approach combined with Glissionian appraoch to perform laparoscopic right anatomic hepatectomy (LRAH). Methods Twenty patients who underwent LRAH from January 2017 to November 2018 were retrospectively analysed. Of these patients, seven patients underwent laparoscopic right hemihepatectomy (LRH group), seven patients who underwent laparoscopic right posterior hepatectomy (LRPH group), and six patients who underwent laparoscopic hepatectomy for segment 7 (LS7 group). The paracaval portion of caudate lobe could be transected firstly through dorsal approach and the corresponding major hepatic vein could be exposed from its root to the peripheral branches safely. Due to exposure along the major hepatic vein trunk, the remaining liver parenchyma could be quickly transected from dorsal to cranial side. Results The mean age of the patients was 53.8 years and the male: female ratio was 8:12. The median operation time was 306.0 ± 58.2 min and the mean estimated volume of blood loss was 412.5 ± 255.4 mL. The mean duration of postoperative hospital stay was 10.2 days. The mean Pringle maneuver time was 64.8 ± 27.7 min. Five patients received transfusion of 2–4 U of red blood cells. Two patients suffered from transient hepatic dysfunction and one suffered from pleural effusion. None of the patients underwent conversion to an open procedure. The operative duration, volume of the blood loss, Pringle maneuver time, and postoperative hospital stay duration did not differ significantly among the LRH, LRPH, and LS7 groups (P > 0.05). Conclusions Dorsal approach combined with Glissonian approach for right lobe is feasible and effective in laparoscopic right anatomic liver resections.


HPB ◽  
2021 ◽  
Vol 23 ◽  
pp. S157
Author(s):  
A. Fagenson ◽  
E. Gleeson ◽  
N. Fatima ◽  
K. Lau ◽  
H. Pitt
Keyword(s):  

2015 ◽  
Vol 77 (4) ◽  
pp. 338-340 ◽  
Author(s):  
S. Goja ◽  
M. K. Singh ◽  
V. Vohra ◽  
A. S. Soin

1930 ◽  
Vol 26 (9) ◽  
pp. 942-942
Author(s):  
H. Bauer

Abstracts. Venereology and Dermatology. Hugo Bauer (D. Z. Bd. 57, H. 4, 29), aiming to study the secretion of myosalvarsan'a, took under observation 4 syphilitics treated with injections of the drug. Excretion of myosalvarsan'a, as well as its absorption, is similar to 'neo' and sulfoxylsalvarsan'y. Most of the arsenobenzol'a introduced into the body is released within a "short time" after injection; four weeks after the cessation of treatment, the body is freed from the maximum amount of introduced As. The author believes that the clinical observations, on the basis of which it is argued that if certain intervals are observed between courses, the cumulative action of As does not occur, are completely fair. The author gives a detailed technique for determining As in selections and supplies the article with visual tables and curves of his own observations.


Author(s):  
Yoshihiro Inoue ◽  
Toru Kuramoto ◽  
Masato Ota ◽  
Kazuya Kitada ◽  
Kensuke Fujii ◽  
...  

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