Laparoscopy-assisted hepatic lobectomy using hilar Glissonean pedicle transection

Area of Science:

• Hepatobiliary Surgery
• Minimally Invasive Surgery
• Surgical Techniques

Background:

• Major hepatic resections (right/left lobectomy) are technically challenging laparoscopically.
• Laparoscopic minor liver resections are well-documented, but major resections lag due to difficulty.
• Advancements are needed to expand laparoscopic approaches for complex liver surgeries.

Purpose of the Study:

• To describe a novel technique for laparoscopy-assisted right or left hepatic lobectomy.
• To evaluate the feasibility and safety of using hilar Glissonean pedicle transection.
• To establish a minimally invasive option for major liver resections.

Main Methods:

• Laparoscopic mobilization of the target hepatic lobe (right or left).
• Laparoscopic encirclement and division of the hilar Glissonean pedicle.
• Parenchymal dissection through a small upper median or right subcostal incision for specimen removal.

Main Results:

• Successful completion of laparoscopy-assisted hepatic lobectomy in 6 patients.
• No patients required blood transfusion.
• No serious intraoperative or postoperative complications were observed.

Conclusions:

• Laparoscopy-assisted hepatic lobectomy utilizing hilar Glissonean pedicle transection is a feasible and safe technique.
• This approach is suitable for highly selected patients undergoing major liver resections.
• Minimally invasive major hepatectomy can be achieved with this innovative method.