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Updated: Jul 7, 2026
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Laparoscopic Left Lateral Sectionectomy: Guided by the Ligamentum Teres Hepatis and the Umbilical Fissure Vein
Published on: September 27, 2024
Laparoscopic versus open left lateral hepatic sectionectomy: A comparative study.
M Abu Hilal1, M J W McPhail, B Zeidan
1Hepatobiliary-Pancreatic and Laparoscopic Surgical Unit, Southampton University Hospital, Southampton, London SO16 6YD, UK. abu_hlal@yahoo.com
Summary
Laparoscopic liver surgery, specifically left lateral sectionectomy (LLS), offers reduced blood loss and shorter hospital stays compared to open procedures. This minimally invasive approach is a viable alternative for liver resections.
Area of Science:
- Hepatobiliary Surgery
- Minimally Invasive Surgery
- Surgical Oncology
Background:
- Laparoscopic liver surgery adoption has been slow.
- Left lateral sectionectomy (LLS) is identified as a key procedure for developing laparoscopic expertise.
- High-volume centers are exploring LLS for laparoscopic transformation.
Purpose of the Study:
- To compare the safety and efficacy of laparoscopic left lateral sectionectomy (LLLS) versus open left lateral sectionectomy (OLLS).
- To evaluate operative time, blood loss, hospital stay, resection margins, and complication rates.
- To assess the learning curve and proficiency gains in LLLS.
Main Methods:
- A comparative study of 44 patients undergoing either LLLS or OLLS for focal lesions.
- Procedures were performed at Southampton General Hospital.
- Data collected included operative time, blood loss, post-operative stay, resection margins, and complications.
Main Results:
- LLLS showed significantly reduced intra-operative blood loss (80 ml vs. 470 ml) and shorter hospital stays (3.5 days vs. 7 days) compared to OLLS.
- Operative times were similar between groups (180 min vs. 155 min).
- Resection margins and complication rates were comparable, with no conversions or 90-day deaths in the LLLS group. Significant improvements in operative time and hospital stay were observed with increasing LLLS experience.
Conclusions:
- LLLS is a safe and effective alternative to OLLS for left lateral sectionectomies.
- LLLS offers advantages in reduced blood loss and shorter hospital stay without compromising resection success or safety.
- Further prospective studies are recommended to validate these findings and expand laparoscopic liver surgery.
