scholarly journals New Technique for Controlling Bleeding in Laparoscopic Liver Resection

2019 ◽  
Vol 4 (03) ◽  
Author(s):  
Luigi Masoni ◽  
Leandro Landi, MD ◽  
Riccardo Maglio, MD
Keyword(s):  
Liver Resection ◽  
Blood Loss ◽  
Laparoscopic Hepatectomy ◽  
Liver Parenchyma ◽  
New Technique ◽  
Solid Organ ◽  
Intraoperative Bleeding ◽  
Endoscopic Clips ◽  
Estimated Blood Loss ◽  
A New Technique

Introduction: The liver is a vascular-rich solid organ. Safe and effective dissection of the vessels and liver parenchyma, and control of intraoperative bleeding are the main concerns when performing liver resection. Controlling bleeding during laparoscopic hepatectomy(LH) is technically demanding, but reportedly associated with less estimated blood loss (EBL) than open surgery. Several studies have confirmed that intraoperative blood loss and postoperative transfusion are predictors of postoperative morbidity and mortality in liver surgery. Various methods and instruments have been developed during hepatectomy. Case presentation: The present study aimed to describe and evaluate hemorrhage control techniques during left lateral partial segmentectomy with use of endoscopic clips. Conclusion: control of intraoperative bleeding it is the most important aspect in liver resection. we propose a new technique for controlling bleeding in restricted operating spaces.

915-MHz microwave-assisted laparoscopic hepatectomy: a new technique for liver resection

2018 ◽  
Vol 33 (2) ◽  
pp. 395-400 ◽  
Author(s):  
Xiaogang Dong ◽  
Zhongquan Sun ◽  
Tianchun Wu ◽  
Wenjia Guo ◽  
Sheng Yan ◽  
...  
Keyword(s):  
Liver Resection ◽  
Laparoscopic Hepatectomy ◽  
New Technique ◽  
Microwave Assisted ◽  
A New Technique

A new technique for liver resection in the dog

1970 ◽  
Vol 11 (6) ◽  
pp. 429-433 ◽  
Author(s):  
J. S. DINGWALL ◽  
J. BOER ◽  
J. ARCHIBALD
Keyword(s):  
Liver Resection ◽  
New Technique ◽  
A New Technique

Safety and Efficacy of Laparoscopic Liver Resection for Colorectal Liver Metastasis With Obesity

2020 ◽  
pp. 000313482095244
Author(s):  
Yoshihiro Inoue ◽  
Masatsugu Ishii ◽  
Kensuke Fujii ◽  
Kentaro Nihei ◽  
Yusuke Suzuki ◽  
...  
Keyword(s):  
Liver Resection ◽  
Blood Loss ◽  
Laparoscopic Liver Resection ◽  
Operative Time ◽  
Surgical Site Infections ◽  
Obese Patients ◽  
Visceral Fat Area ◽  
Safety And Efficacy ◽  
Estimated Blood Loss ◽  
Significant Difference

Introduction Laparoscopic liver resection (LLR) in obese patients has been reported to be particularly challenging owing to technical difficulties and various comorbidities. Methods The safety and efficacy outcomes in 314 patients who underwent laparoscopic or open nonanatomical liver resection for colorectal liver metastases (CRLM) were analyzed retrospectively with respect to the patients’ body mass index (BMI) and visceral fat area (VFA). Results Two hundred and four patients underwent LLR, and 110 patients underwent open liver resection (OLR). The rate of conversion from LLR to OLR was 4.4%, with no significant difference between the BMI and VFA groups ( P = .647 and .136, respectively). In addition, there were no significant differences in terms of operative time and estimated blood loss in LLR ( P = .226 and .368; .772 and .489, respectively). The incidence of Clavien-Dindo grade IIIa or higher complications was not significantly different between the BMI and VFA groups of LLR ( P = .877 and .726, respectively). In obese patients, the operative time and estimated blood loss were significantly shorter and lower, respectively, in LLR than in OLR ( P = .003 and < .001; < .001 and < .001, respectively). There was a significant difference in the incidence of postoperative complications, organ/space surgical site infections, and postoperative bile leakage between the LLR and OLR groups ( P = .017, < .001, and < .001, respectively). Conclusion LLR for obese patients with CRLM can be performed safely using various surgical devices with no major difference in outcomes compared to those in nonobese patients. Moreover, LLR has better safety outcomes than OLR in obese patients.

scholarly journals Single-Institution Early Experience and Learning Curve with Robotic Liver Resections

2019 ◽  
Vol 85 (1) ◽  
pp. 115-119 ◽  
Author(s):  
Aviad Gravetz ◽  
Iswanto Sucandy ◽  
Chandler Wilfong ◽  
Nirrita Patel ◽  
Janelle Spence ◽  
...  
Keyword(s):  
Liver Resection ◽  
Blood Loss ◽  
Learning Curve ◽  
Intraoperative Complications ◽  
Length Of Hospital Stay ◽  
Early Experience ◽  
Robotic Liver Resection ◽  
Open Operation ◽  
Estimated Blood Loss ◽  
Posterosuperior Segment

Robotic liver resection is being introduced with its potential to overcome limitations of conventional laparoscopy. This study was undertaken to document early experience and learning curve of robotic liver resection in our institution. All patients undergoing liver resection between 2013 and 2017 were prospectively followed. Patients were divided into three consecutive tertiles (cohort I–III). Thirty-three patients underwent robotic liver resection within the study period. Twenty-four per cent of patients underwent formal right or left hemihepatectomy, 21 per cent underwent sectionectomy, 6 per cent underwent central hepatectomy, and the remainder underwent non-anatomical liver resection. Formal hemihepatectomy and right posterosuperior segment resection were undertaken in two patients in cohort I, four patients in cohort II, and four patients in cohort III. Two cases were converted to “open” operation. Operative time was 172 (194.5 ± 65.1) minutes in cohort I, 222 (247.8 ± 109.8) minutes in cohort II, and 280 (302.5 ± 84.9) minutes in cohort III, reflecting increasing degree of technical complexity. Estimated blood loss decreased significantly throughout the cohorts, being 400 mL, 200 mL, and 100 mL in cohorts I to III, respectively. Major intraoperative complications were not seen. Three patients experienced postoperative complications, resulting in a single mortality. Length of hospital stay was three days, with two patients being readmitted within 30 days. Robotic technique for liver resection is feasible and safe. It offers good short-term clinical outcomes, including for patients who require major liver resection. As the proficiency developed, a notable improvement in technically ability to undertake more complex resections with decreasing blood loss and minimal morbidity was seen.

scholarly journals Semi-spherical Radiofrequency Bipolar Device – A New Technique for Liver Resection

2014 ◽  
Vol 14 (5) ◽  
pp. 573-582 ◽  
Author(s):  
P. Vavra ◽  
M. Penhaker ◽  
J. Jurcikova ◽  
M. Skrobankova ◽  
M. Crha ◽  
...  
Keyword(s):  
Liver Resection ◽  
New Technique ◽  
A New Technique ◽  
Bipolar Device

scholarly journals Hepatectomy using a combination of extrafascial extrahepatic (Takasaki approach) and extrafascial intrahepatic pedicle approaches (Ton That Tung approach)

2021 ◽  
Vol 2021 (10) ◽  
Author(s):  
Quyet Van Ha ◽  
Toan Huy Nguyen ◽  
Huong Van Nguyen ◽  
Xuan Anh Le ◽  
Kinh Huy Tran
Keyword(s):  
Liver Resection ◽  
Future Liver Remnant ◽  
Liver Parenchyma ◽  
Liver Remnant ◽  
Ischemic Time ◽  
Precise Knowledge ◽  
Safe Technique ◽  
Glissonean Pedicle ◽  
A New Technique ◽  
Anatomical Liver Resection

Abstract Selective pedicle control and anatomical liver resection are considered standard techniques in hepatectomy for hepatocellular carcinoma. In 1963, Ton That Tung made significant improvements in hepatectomy techniques with the principle of locating and ligation of Glissonean pedicle in the liver parenchyma based on precise knowledge of vascular and biliary anatomy (Tung TT, Quang ND. A new technique for operating on the liver. Lancet 1963;281:192–3). In 1986, the extrafascial Glissonean dissection was first introduced by Takasaki in 1986. This is a simple and safe technique that helps to identify the exact borders between liver sections for anatomic liver resection (Takasaki K. Glissonean pedicle transection method for hepatic resection: a new concept of liver segmentation. J Hepatobiliary Pancreat Surg 1998;5:286–91). The combination of two techniques helps minimize complications, reduce ischemic time of future liver remnant, intraoperative blood loss and avoid migration of cancer cells into other segments.

scholarly journals A New Technique for Liver Resection. identification of the Intersubsegmental Plane in the Liver Using A hemoclip.

1992 ◽  
Vol 25 (1) ◽  
pp. 122-126
Author(s):  
Takando Sakairi ◽  
Tetsufumi Kojima ◽  
Eiji Shimozawa ◽  
Hiroyuki Kato ◽  
Tatsuzo Tanabe
Keyword(s):  
Liver Resection ◽  
New Technique ◽  
A New Technique
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