Use of intercostal trocars for laparoscopic resection of subphrenic hepatic tumors View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2016-07-21

AUTHORS

Hirofumi Ichida, Takeaki Ishizawa, Masayuki Tanaka, Muga Terasawa, Genki Watanabe, Yoshinori Takeda, Ryota Matsuki, Masaru Matsumura, Taigo Hata, Yoshinori Mise, Yosuke Inoue, Yu Takahashi, Akio Saiura

ABSTRACT

BackgroundThe aim of this study was to demonstrate the detailed surgical techniques of laparoscopic hepatectomy using intercostal transthoracic trocars for subcapsular tumors located in segment VII or VIII.MethodsIntercostal transthoracic trocars were used in patients undergoing laparoscopic hepatectomy for tumors located in segment VII or VIII. Following establishment of pneumoperitoneum and placement of abdominal trocars, balloon-tipped trocars were inserted into the abdominal cavity from the intercostal space and through the pleural space and diaphragm. Upon placement of the intercostal trocars, the lung edge was confirmed by ultrasonography and laparoscopic examination. Following minimal mobilization of the right liver, hemispherical wedge resection of segment VII or VIII was performed using the intercostal trocars as a camera port or for the forceps of the surgeon’s left hand. After the hepatectomy, the holes in the diaphragm were sutured closed.ResultsAmong the 79 patients who underwent laparoscopic hepatectomy, intercostal trocars were used in 14 patients for resection of tumors located in segment VII (4 nodules) or VIII (10 nodules). The median (range) operation time and amount of blood loss for hepatectomy were 225 (109–477) min and 60 (20–310) mL, respectively. No postoperative complications associated with hepatectomy or the use of intercostal trocars occurred.ConclusionsUse of intercostal transthoracic trocars is safe and effective not only for complicated laparoscopic hepatectomy but also for hemispherical wedge resections of subcapsular hepatic tumors located in segment VII or VIII. More... »

PAGES

1280-1286

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00464-016-5107-3

DOI

http://dx.doi.org/10.1007/s00464-016-5107-3

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1010439806

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/27444836


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