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Updated: May 13, 2026
Laparoscopic Anatomical Liver Segment VII Resection with Liver Parenchymal Transection Following a Priority Approach
Published on: May 23, 2025
Upper midline incision for liver resection
Seoung Hoon Kim1, Young Kyu Kim
1Centre for Liver Cancer, National Cancer Centre, Goyang-si, Gyeonggi-do 410-769, South Korea. kshlj@hanmail.net
Objectives:
The optimal incision for liver resection in living donors or patients with small tumours should be revisited. This study introduces the upper midline incision (UMI) above the umbilicus for various liver resections using a conventional open-surgery technique.
Methods:
A retrospective study based on a prospectively collected database of 308 liver resections performed by a single surgeon was conducted to evaluate the feasibility, safety and applicability of the UMI.
Results:
From September 2006 to September 2010, this incision was used successfully in 308 consecutive liver resections in all patients with tumours measuring ≤ 5 cm and all living donors without any extension of the incision. The median length of the incision was 16.4 cm (range: 12-20 cm).The median operating time was 189 min (range: 54-305 min). The median postoperative hospital stay was 8 days (range: 6-17 days). One patient died in the postoperative period from heart failure. All other patients fully recovered and returned to their previous level of activity. Over a median follow-up of 31 months (range: 20-68 months), 25 complications (8.1%) developed. Seven wound infections (2.3%) occurred with no incisional hernia.
Conclusions:
The UMI can be used safely and effectively in conventional open surgery in various liver resections and should therefore be given priority as the first-line technique in living liver donors and patients with tumours measuring ≤ 5 cm.
