Minimally Invasive Left Hepatectomy: Choosing the Suitable Surgical Strategy

Overview

Journal Ann Surg Oncol

Publisher Springer

Specialty Oncology

Date 2024 Jul 30

PMID 39080131

Authors

Gemma Vellalta

Benedetto Ielpo

Mayra Abad

Maria Vittoria dAddetta

Patricia Sanchez-Velazquez

Vito De Blasi

Fernando Burdio

Edoardo Rosso

Affiliations

Soon will be listed here.

Abstract

Background: Numerous surgical techniques are currently available for minimally invasive left hepatic resection, each offering its own advantages and disadvantages.

Patients And Methods: This multimedia manuscript delves into the primary approaches for minimally invasive left hepatectomy, with a focus on particular topics such as left hepatic vein approach, transection and middle hepatic vein exposure, and Glissonean approach. We examine key factors that surgeons should consider when choosing among these methods and provide practical recommendations.

Results: To enhance understanding, our article includes video footage from multiple centres, showcasing expertly executed surgeries for each approach along with their main considerations.

Conclusions: This multimedia resource will serve as a valuable guide for surgeons, aiding in the selection of the most suitable strategy for minimally invasive left hepatectomies, tailored to the specific needs of the patient and the characteristics of the lesion.

References

Nguyen K, Clark Gamblin T, Geller D . World review of laparoscopic liver resection-2,804 patients. Ann Surg. 2009; 250(5):831-41. DOI: 10.1097/SLA.0b013e3181b0c4df. View

Reich H, McGlynn F, DeCaprio J, Budin R . Laparoscopic excision of benign liver lesions. Obstet Gynecol. 1991; 78(5 Pt 2):956-8. View

Kaneko H, Takagi S, Shiba T . Laparoscopic partial hepatectomy and left lateral segmentectomy: technique and results of a clinical series. Surgery. 1996; 120(3):468-75. DOI: 10.1016/s0039-6060(96)80065-1. View

Azagra J, Goergen M, Gilbart E, Jacobs D . Laparoscopic anatomical (hepatic) left lateral segmentectomy-technical aspects. Surg Endosc. 1996; 10(7):758-61. DOI: 10.1007/BF00193052. View

Nitta H, Sasaki A, Fujita T, Itabashi H, Hoshikawa K, Takahara T . Laparoscopy-assisted major liver resections employing a hanging technique: the original procedure. Ann Surg. 2010; 251(3):450-3. DOI: 10.1097/SLA.0b013e3181cf87da. View

Cho A, Yamamoto H, Kainuma O, Ota T, Park S, Yanagibashi H . Arantius' ligament approach for the left extrahepatic Glissonean pedicle in pure laparoscopic left hemihepatectomy. Asian J Endosc Surg. 2012; 5(4):187-90. DOI: 10.1111/j.1758-5910.2012.00139.x. View

Rotellar F, Pardo F, Benito A, Marti-Cruchaga P, Zozaya G, Pedano N . A novel extra-glissonian approach for totally laparoscopic left hepatectomy. Surg Endosc. 2012; 26(9):2617-22. DOI: 10.1007/s00464-012-2242-3. View

Troisi R, Montalti R . Modified hanging maneuver using the goldfinger dissector in laparoscopic right and left hepatectomy. Dig Surg. 2013; 29(6):463-7. DOI: 10.1159/000345996. View

Honda G, Kurata M, Okuda Y, Kobayashi S, Tadano S, Yamaguchi T . Totally laparoscopic hepatectomy exposing the major vessels. J Hepatobiliary Pancreat Sci. 2012; 20(4):435-40. DOI: 10.1007/s00534-012-0586-7. View

10.

Takasaki K . Glissonean pedicle transection method for hepatic resection: a new concept of liver segmentation. J Hepatobiliary Pancreat Surg. 1999; 5(3):286-91. DOI: 10.1007/s005340050047. View

11.

Couinaud C . A simplified method for controlled left hepatectomy. Surgery. 1985; 97(3):358-61. View

12.

Sugioka A, Kato Y, Tanahashi Y . Systematic extrahepatic Glissonean pedicle isolation for anatomical liver resection based on Laennec's capsule: proposal of a novel comprehensive surgical anatomy of the liver. J Hepatobiliary Pancreat Sci. 2017; 24(1):17-23. PMC: 5299460. DOI: 10.1002/jhbp.410. View

13.

Figueras J, Lopez-Ben S, Llado L, Rafecas A, Torras J, Ramos E . Hilar dissection versus the "glissonean" approach and stapling of the pedicle for major hepatectomies: a prospective, randomized trial. Ann Surg. 2003; 238(1):111-9. PMC: 1422665. DOI: 10.1097/01.SLA.0000074981.02000.69. View

14.

Ielpo B, Giuliani A, Sanchez P, Burdio F, Gastaka M, Di Martino M . Laparoscopic glissonean pedicle approach: step by step video description of the technique from different centres (with video). Updates Surg. 2022; 74(3):1149-1152. DOI: 10.1007/s13304-021-01219-9. View

15.

Chaib E, Kanas A, Galvao F, Carneiro DAlbuquerque L . Bile duct confluence: anatomic variations and its classification. Surg Radiol Anat. 2013; 36(2):105-9. DOI: 10.1007/s00276-013-1157-6. View

16.

Clipet F, Rebibo L, Dembinski J, Yzet T, Vilgrain V, Regimbeau J . Portal vein variants associated with right hepatectomy: An analysis of abdominal CT angiography with 3D reconstruction. Clin Anat. 2018; 32(3):328-336. DOI: 10.1002/ca.23315. View

17.

Sureka B, Patidar Y, Bansal K, Rajesh S, Agrawal N, Arora A . Portal vein variations in 1000 patients: surgical and radiological importance. Br J Radiol. 2015; 88(1055):20150326. PMC: 4743455. DOI: 10.1259/bjr.20150326. View

18.

Wakabayashi T, Benedetti Cacciaguerra A, Abe Y, Dalla Bona E, Nicolini D, Mocchegiani F . Indocyanine Green Fluorescence Navigation in Liver Surgery: A Systematic Review on Dose and Timing of Administration. Ann Surg. 2022; 275(6):1025-1034. DOI: 10.1097/SLA.0000000000005406. View

19.

Okuda Y, Honda G, Kurata M, Kobayashi S, Sakamoto K . Dorsal approach to the middle hepatic vein in laparoscopic left hemihepatectomy. J Am Coll Surg. 2014; 219(2):e1-4. DOI: 10.1016/j.jamcollsurg.2014.01.068. View

20.

Kim J . Laparoscopy-specific ventral approach in laparoscopic hemihepatectomy. J Surg Oncol. 2017; 116(2):159-163. DOI: 10.1002/jso.24636. View