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Extended subcostal hinge incision for right hepatic lobectomy
S A Ahrendt1, L Schlossberg, G B Bulkley
1Department of Surgery, Medical College of Wisconsin, Milwaukee 53326, USA.
The American Surgeon
|August 4, 1999
Summary
This study describes an extended subcostal incision technique for right hepatic lobectomy. This surgical approach provides adequate exposure of the hepatic veins and vena cava, avoiding chest wall openings.
Area of Science:
- Hepatobiliary Surgery
- Surgical Oncology
- Abdominal Surgery
Background:
- Right hepatic lobectomy is a complex procedure requiring optimal surgical field exposure.
- Adequate visualization of hepatic veins and the suprahepatic vena cava is critical for safe execution.
- Standard incisions like midline or extended subcostal approaches are commonly employed.
Purpose of the Study:
- To describe a specific technique for an extended subcostal incision.
- To demonstrate how this incision utilizes the rib cage's natural hinge mechanism.
- To evaluate its efficacy in providing exposure for right hepatic lobectomy.
Main Methods:
- Detailed description of the extended subcostal incision technique.
- Emphasis on leveraging the rib cage's biomechanical properties for enhanced exposure.
- Application of the technique during right hepatic lobectomy procedures.
Main Results:
- The described subcostal incision technique provides sufficient exposure of the right upper quadrant.
- This approach facilitates adequate visualization of the hepatic veins and suprahepatic vena cava.
- The technique successfully avoids the necessity of thoracotomy or sternotomy.
Conclusions:
- The described extended subcostal incision is a safe and effective method for right hepatic lobectomy.
- This technique offers a valuable alternative to more invasive surgical approaches.
- It ensures adequate exposure for challenging hepatectomy cases.