Laparoscopic Left Lateral Sectionectomy. Presentation of Our Technique

• Published in: Cirugia española (English ed.) Vol. 89; no. 10; pp. 650 - 656
• Main Authors: Herrero Fonollosa, E, Cugat Andorra, E, García-Domingo, M.I, Rivero Deniz, J, Camps Lasa, J, Rodríguez Campos, A, Riveros Caballero, M, Marco Molina, C
• Format: Journal Article
• Language: English
• Published: Elsevier España 01-12-2011
• Subjects: Hepatectomy; Hepatectomía; Laparoscopia; Laparoscopy; Seccionectomía; Sectionectomy; Surgery; Laparoscopy; Sectionectomy; Seccionectomía; Hepatectomía; Laparoscopia; Hepatectomy
• ISSN: 2173-5077; 2173-5077
• DOI: 10.1016/j.cireng.2011.06.007

Abstract Introduction Laparoscopy has not been as widely used in hepatic surgery as in other areas due to the complexity of this type of surgery and the lack of surgical teams with experience in both fields. Material and methods The aim of this work is to present the technique used in our centre to perform left lateral sectionectomy (LLS) using laparoscopy. A total of 70 patients have been operated on using laparoscopy due to both benign and malignant liver between February 2000 and July 2010. An LLS was performed on twenty-one cases using the technique described. The surgical technique is described, highlighting aspects such as, the arrangement of the trocars, the mobilisation of the liver or hepatic transection. The morbidity and mortality associated with the procedure are analysed. Results LLS was performed on 12 women and nine men, with ages between 35 and 89 years. The mean number of lesions was 1.4 (between 1 and 4), with a mean size of 3.5 cm. The mean surgical time was 142 min (between 90 and 210). There was one conversion to laparotomy. Complications were recorded in 3 (14%) patients. There were no repeat surgery, and one patient required a transfusion. The mean hospital stay was 4.3 days. Conclusions The best techniques and the wide experience in laparoscopy have enabled this technique to become established, with a morbidity of less than 15% and zero mortality. LLS is a safe and effective technique in selected patients. The detailed description of this procedure may stimulate other surgery groups to perform this approach.