Laparoscopic hand-assisted right hemihepatectomy by ultrasound-directed intrahepatic approach

Giulio Belli, Alberto D'Agostino, Corrado Fantini, Andrea Belli, Luigi Cioffi, Paolo Limongelli, Gianluca Russo

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background/purpose: Laparoscopic hepatectomy is a promising option for patients affected by a liver mass, and the procedure is gaining popularity. Minor laparoscopic resections have been widely reported. In contrast, major laparoscopic hepatectomy has been performed in only a limited number of cases. Hand-assisted laparoscopic liver surgery has been advocated in order to improve liver exposure and vascular control and increase the safety of the procedure. Transparenchymal en-bloc transection of the right portal triad has been reported to be safe and useful in open surgery. Methods: We describe a personal technique for hand-assisted right hemihepatectomy. With ultrasound guidance, the right hepatic pedicle is isolated intrahepatically and transected en bloc with a single firing of an endostapler. Parenchymal transection is carried out with ultrasonically activated or vessel-sealing devices together with endostaplers. Results: The procedure was successfully accomplished in three patients. The Pringle maneuver was never performed. No intraoperative or postoperative complications occurred. Conclusion: This study is the first to report a technique of right hemihepatectomy that combines hand-assisted laparoscopy and an ultrasound-guided intrahepatic approach. This technique may be a useful option to simplify the operation, reduce operative time, and increase the safety of the procedure.

Original languageEnglish
Pages (from-to)781-785
Number of pages5
JournalJournal of Hepato-Biliary-Pancreatic Surgery
Volume16
Issue number6
DOIs
Publication statusPublished - Nov 2009

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Hand
Hand-Assisted Laparoscopy
Liver
Hepatectomy
Safety
Intraoperative Complications
Operative Time
Blood Vessels
Equipment and Supplies

Keywords

  • Hand-assisted laparoscopy
  • Laparoscopic hepatic resection
  • Laparoscopic intrahepatic approach
  • Laparoscopic right hepatectomy

ASJC Scopus subject areas

  • Surgery
  • Hepatology

Cite this

Belli, G., D'Agostino, A., Fantini, C., Belli, A., Cioffi, L., Limongelli, P., & Russo, G. (2009). Laparoscopic hand-assisted right hemihepatectomy by ultrasound-directed intrahepatic approach. Journal of Hepato-Biliary-Pancreatic Surgery, 16(6), 781-785. https://doi.org/10.1007/s00534-009-0156-9

Laparoscopic hand-assisted right hemihepatectomy by ultrasound-directed intrahepatic approach. / Belli, Giulio; D'Agostino, Alberto; Fantini, Corrado; Belli, Andrea; Cioffi, Luigi; Limongelli, Paolo; Russo, Gianluca.

In: Journal of Hepato-Biliary-Pancreatic Surgery, Vol. 16, No. 6, 11.2009, p. 781-785.

Research output: Contribution to journalArticle

Belli, G, D'Agostino, A, Fantini, C, Belli, A, Cioffi, L, Limongelli, P & Russo, G 2009, 'Laparoscopic hand-assisted right hemihepatectomy by ultrasound-directed intrahepatic approach', Journal of Hepato-Biliary-Pancreatic Surgery, vol. 16, no. 6, pp. 781-785. https://doi.org/10.1007/s00534-009-0156-9
Belli, Giulio ; D'Agostino, Alberto ; Fantini, Corrado ; Belli, Andrea ; Cioffi, Luigi ; Limongelli, Paolo ; Russo, Gianluca. / Laparoscopic hand-assisted right hemihepatectomy by ultrasound-directed intrahepatic approach. In: Journal of Hepato-Biliary-Pancreatic Surgery. 2009 ; Vol. 16, No. 6. pp. 781-785.
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