Laparoscopic liver right posterior sectionectomies; surgical technique and clinical results of a single surgeon experience
1Department of of General Surgery, Gülhane Training and Research Hospital, University of Health Sciences, Ankara, Turkey
2Department of General Surgery, Lokman Hekim University Faculty of Medicine, Ankara, Turkey
Objective: 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.
Keywords: Hepatobiliary surgery, laparoscopic, liver resection, right posterior, sectionectomy, techniques
Cite this article as: Öztaş M, Lapsekili E, Can MF. Laparoscopic liver right posterior sectionectomies; surgical technique and clinical results of a single surgeon experience. Turk J Surg 2022; 38 (1): 18-24.
The approval for this study was obtained from Gülhane Training and Research Hospital Ethics Committee (Decision no: 2021/70, Date: 29.09.2021).
Concept - All of authors; Design - All of authors; Supervision - M.F.C.; Materials - E.L., M.Ö.; Data Collection and/or Processing - E.L., M.Ö.; Analysis and/or Interpretation - E.L., M.Ö.; Literature Search - M.Ö., E.L.; Writing Manuscript - All of authors; Critical Reviews - M.F.C..
The authors have no conflicts of interest to declare.
The authors declared that this study has received no financial support.