Extending the limitations of liver surgery: outcomes of initial human experience in a high-volume center performing single-port laparoscopic liver resection for hepatocellular carcinoma

• Published in: Surgical endoscopy Vol. 26; no. 6; pp. 1602 - 1608
• Main Authors: Shetty, Guruprasad S., You, Young Kyoung, Choi, Ho Joong, Na, Gun Hyung, Hong, Tae Ho, Kim, Dong-Goo
• Format: Journal Article
• Language: English
• Published: New York Springer-Verlag 01.06.2012; Springer; Springer Nature B.V
• Subjects: Abdominal Surgery; Adult; Aged; Aged, 80 and over; Biological and medical sciences; Carcinoma, Hepatocellular - surgery; Digestive system. Abdomen; Dissection; Endoscopy; Equipment Design; Feasibility Studies; Female; Gastroenterology; General aspects; Gynecology; Hepatectomy; Hepatectomy - methods; Hepatology; Humans; Investigative techniques, diagnostic techniques (general aspects); Laparoscopes; Laparoscopy; Laparoscopy - instrumentation; Laparoscopy - methods; Length of Stay - statistics & numerical data; Liver cancer; Liver Neoplasms - surgery; Liver, biliary tract, pancreas, portal circulation, spleen; Male; Medical sciences; Medicine; Medicine & Public Health; Middle Aged; Neoplasm Recurrence, Local - etiology; Patients; Proctology; Surgeons; Surgery; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the digestive system; Surgical Instruments; Tomography; Treatment Outcome; United States > US; Japan; Single port; Hepatocellular carcinoma; Laparoscopy; Liver resection; Human; Endoscopic surgery; Prognosis; Digestive system; Liver; Hepatic disease; Malignant tumor; Hepatectomy; Medicine; Treatment; Digestive diseases; Endoscopy; Cancer
• ISSN: 0930-2794; 1432-2218
• DOI: 10.1007/s00464-011-2077-3

Background Single-port laparoscopic surgery is slowly but steadily gaining popularity among surgeons performing minimally invasive abdominal surgeries. The aim of the present study is to assess our initial experience with single-port laparoscopic liver resection for hepatocellular carcinoma. Methods Between March 2009 and April 2011, 24 patients underwent single-port laparoscopic liver resection for hepatocellular carcinoma. Of these, 13 were laparoscopic segmentectomies, 4 were laparoscopic left lateral sectionectomies, 1 was a right hepatectomy, 1 was a left hepatectomy, and 4 were nonanatomical resections. Results Median operating time and blood loss were 205 min (95–545 min) and 500 ml (100–2,500 ml), respectively. Two procedures were converted to multiport laparoscopic hepatectomy due to instrument length limitations, and four were converted to open surgery. There were no serious intraoperative or postoperative complications in this series. Median postoperative stay was 8.5 days (5–16 days). Conclusions Although the procedure requires a lot of technical expertise added to the skill of liver surgery, single-port laparoscopic liver resection for hepatocellular carcinoma seems a feasible approach in a variety of well-selected cases. In spite of the demanding nature of the procedure and the requirement of better instrumentation for single-port laparoscopic surgery, the results seem to compare favorably with conventional laparoscopic surgery and open surgery.