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Related Experiment Video

Updated: Jun 23, 2026

Application of the En Bloc Concept Combined with Anatomic Resection in Laparoscopic Hepatectomy
04:41

Application of the En Bloc Concept Combined with Anatomic Resection in Laparoscopic Hepatectomy

Published on: March 10, 2023

Starting a laparoscopic hepatectomy programme.

E Wang1, A W Kow, C Y Chan

  • 1Digestive Disease Centre, Hepatobiliary and Pancreatic Surgery Service, Centre for Advanced Laparoscopic Surgery, Department of General Surgery, Tan Tock Seng Hospital, 11 Jalan Tan Tock Seng, Singapore.

Singapore Medical Journal
|May 8, 2009
PubMed
Summary
This summary is machine-generated.

Stringent patient selection in laparoscopic liver resection leads to favorable outcomes. This approach, even in early stages, ensures results comparable to experienced centers, benefiting patients with less pain and faster recovery.

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Last Updated: Jun 23, 2026

Application of the En Bloc Concept Combined with Anatomic Resection in Laparoscopic Hepatectomy
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Area of Science:

  • Minimally invasive surgery
  • Hepatobiliary surgery
  • Surgical oncology

Background:

  • Laparoscopic hepatectomy offers advantages over open procedures, including reduced patient pain, faster recovery, and shorter hospital stays.
  • Several centers in Singapore have adopted laparoscopic hepatectomy.
  • Careful patient selection is crucial for mastering the learning curve of this technique.

Purpose of the Study:

  • To review the initial outcomes of laparoscopic anatomical liver resections at our center.
  • To evaluate the efficacy of stringent patient selection criteria in a new laparoscopic hepatectomy program.

Main Methods:

  • Patients were selected based on criteria from experienced centers, focusing on small lesions in specific liver segments (II, III, IVB, V, VI).
  • Standardized surgical techniques included intraoperative ultrasonography, ultrasonic shears, surgical staplers for transection, and specimen retrieval via a Pfannenstiel incision.
  • No hand ports were utilized, and patient records were retrospectively reviewed.

Main Results:

  • Five consecutive patients underwent laparoscopic anatomical liver resection between July 2006 and August 2007.
  • The median age of patients was 50 years; four had hepatocellular carcinoma and one had a liver abscess.
  • Median operation time was 275 minutes, with a median intraoperative blood loss of 400 ml and a median hospital stay of 4 days.

Conclusions:

  • Stringent patient selection criteria and surgical expertise are vital for successful initial laparoscopic hepatectomy programs.
  • Favorable outcomes comparable to established centers can be achieved even during the early stages of implementation.
  • This approach supports the safe expansion of laparoscopic liver surgery.