Skip to main content

Advertisement

Log in

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:
Surgical Endoscopy Aims and scope Submit manuscript

Abstract

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Dagher I, Proske JM, Carloni A, Richa H, Tranchart H, Franco D (2007) Laparoscopic liver resection: results for 70 patients. Surg Endosc 21:619–624

    Article  PubMed  CAS  Google Scholar 

  2. Navarra G, Pozza E, Occhiorelli S, Carcoforo P, Donini I (1997) One-wound laparoscopic cholecystectomy. Br J Surg 84:695

    Article  PubMed  CAS  Google Scholar 

  3. Hong TH, Kim HL, Lee YS, kim JJ, Lee KH, You YK et al (2009) Transumbilical single-port laparoscopic appendectomy (TUSPLA): scarless intracorporeal appendectomy. J Laparoendosc Surg Tech A 19:75–78

    Article  Google Scholar 

  4. Hong TH, You YK, Lee KH (2009) Transumbilical single-port cholecystectomy: scarless cholecystectomy. Surg Endosc 23:1393–1397

    Article  PubMed  Google Scholar 

  5. Castellucci SA, Curcillo PG, Ginsberg PC, Saba SC, Jaffe JS, Harmon JD (2008) Single port access adrenalectomy. J Endourol 22:1573–1576

    Article  PubMed  Google Scholar 

  6. Kaouk JH, Haber GP, Goel RK, Desai MM, Aron M, Rackley RR et al (2008) Single-port laparoscopic surgery in urology: initial experience. Urology 71:3–6

    Article  PubMed  Google Scholar 

  7. Ghezzi F, Cromi A, Fasola M, Bolis P (2005) One-trocar salpingectomy for the treatment of tubal pregnancy: a ‘marionette-like’ technique. BJOG 112:1417–1419

    Article  PubMed  Google Scholar 

  8. Kim JH, You YK, Hong TH, Lee SK, Park JH, Yoon YC, Kim JG (2010) Single-port laparoscopic cholecystectomy: a comparative study in 106 initial cases. Asian J Endosc Surg 3:127–132

    Article  Google Scholar 

  9. Koffron AJ, Auffenberg G, Kung R, Abecassis M (2007) Evaluation of 300 minimally invasive liver resections at a single institution: less is more. Ann Surg 246:385–394

    Article  PubMed  Google Scholar 

  10. Sasaki A, Nitta H, Otsuka K, Takahara T, Nishizuka S, Wakabayashi G (2009) Ten-year experience of totally laparoscopic liver resection in a single institution. Br J Surg 96:274–279

    Article  PubMed  CAS  Google Scholar 

  11. Cherqui D, Laurent A, Tayar C, Chang S, Van Nhieu JT, Loriau J et al (2006) Laparoscopic liver resection for peripheral hepatocellular carcinoma in patients with chronic liver disease: midterm results and perspectives. Ann Surg 243:499–506

    Article  PubMed  Google Scholar 

  12. Cho JY, Han HS, Yoon YS, Shin SH (2009) Outcomes of laparoscopic liver resection for lesions located in the right side of the liver. Arch Surg 144:25–29

    Article  PubMed  Google Scholar 

  13. Kalloo AN, Singh VK, Jagannath SB, Niiyama H, Hill SL, Vaughn CA et al (2004) Flexible transgastric peritoneoscopy: a novel approach to diagnostic and therapeutic interventions in the peritoneal cavity. Gastrointest Endosc 60:114–117

    Article  PubMed  Google Scholar 

  14. Pearl JP, Ponsky JL (2008) Natural orifice transluminal endoscopic surgery: a critical review. J Gastrointest Surg 12:1293–1300

    Article  PubMed  Google Scholar 

  15. Mintz Y, Horgan S, Cullen J, Stuart D, Falor E, Talamini MA (2008) NOTES: a review of the technical problems encountered and their solutions. J Laparoendosc Adv Surg Tech A 18:583–587

    Article  PubMed  Google Scholar 

  16. Piskun G, Rajpal S (1999) Transumbilical laparoscopic cholecystectomy utilizes no incision outside the umbilicus. J Laparoendosc Adv Surg Tech A 9:361–364

    Article  PubMed  CAS  Google Scholar 

  17. Romanelli JR, Earle DB (2009) Single-port laparoscopic surgery. Surg Endosc 23:1419–1427

    Article  PubMed  Google Scholar 

  18. Rao PP, Rao PP, Bhagwat S (2011) Single-incision laparoscopic surgery—current status and controversies. J Minim Access Surg 7:6–16

    PubMed  Google Scholar 

  19. McCormack L, Capitanich P, Quiñonez E (2008) Liver surgery in the presence of cirrhosis or steatosis: is morbidity increased? Patient Saf Surg 25(2):8

    Article  Google Scholar 

Download references

Disclosures

Authors Guruprasad S. Shetty, Young Kyoung You, Ho Joong Choi, Gun Hyung Na, Tae Ho Hong, and Dong-Goo Kim have no conflicts of interest or financial ties to disclose.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Young Kyoung You.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Shetty, G.S., You, Y.K., Choi, H.J. et al. 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. Surg Endosc 26, 1602–1608 (2012). https://doi.org/10.1007/s00464-011-2077-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00464-011-2077-3

Keywords

Navigation