Laparoscopy-Assisted Donor Right Hepatectomy Using a Hand Port System Preserving the Middle Hepatic Vein Branches View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2009-03

AUTHORS

Kyung-Suk Suh, Nam-Joon Yi, Taehoon Kim, Joohyun Kim, Woo Young Shin, Hae Won Lee, Ho-Seong Han, Kuhn Uk Lee

ABSTRACT

BACKGROUND: This report reviews our experience with a modified right hepatectomy (MRH) using laparoscopic or laparoscopy-assisted techniques preserving the middle hepatic vein (MHV) branches in living donor liver transplantation. METHODS: Nine female donors (17-36 years) underwent a laparoscopic MRH under pneumoperitoneum (L-MRH; n = 2) or a laparoscopy-assisted MRH (LA-MRH; n = 7) with a hand port device. The donors for this minimally invasive surgery were volunteers with the willingness to undergo laparoscopic surgery and recipients who were not in urgent need of transplantation. Mobilization of the right liver was performed under pneumoperitoneum in all cases. Hilar dissection and parenchymal transection were performed under pneumoperitonuem (n = 2) or with a mini-laparotomy incision (n = 7) using an ultrasonic aspirator without the Pringle maneuver. The major MHV branches (>5 mm) were preserved using Hem-o-lock clips. The graft was extracted through the site of the hand port device or the mini-laparotomy. On the back table, the MHV branches were reconstructed with an artificial vascular graft. RESULTS: There were no open conversions, and the graft was transplanted without any problem in every case. The operative time for the donors was 765 min and 898 min in the L-MRH patients, and it ranged from 310 to 575 min for the laparoscopy-assisted surgery. None of the donors required transfusion or reoperation; they were discharged on postoperative day 8-14 with normal liver function. A major complication occurred in one donor; fluid collection along the liver resection margin with fever was treated and resolved after percutaneous drainage. CONCLUSIONS: A right hepatectomy preserving the MHV or its branches by minimally invasive techniques including total laparoscopic surgery was technically feasible. However, further refinements of the procedure are required prior to wide clinical application. More... »

PAGES

526-533

References to SciGraph publications

  • 2004-02. Laparoscopic right hepatectomy: Surgical technique in JOURNAL OF GASTROINTESTINAL SURGERY
  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1007/s00268-008-9842-z

    DOI

    http://dx.doi.org/10.1007/s00268-008-9842-z

    DIMENSIONS

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    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/19115031


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