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Updated: May 8, 2026
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Application of the En Bloc Concept Combined with Anatomic Resection in Laparoscopic Hepatectomy
Published on: March 10, 2023
Thoracoscopic hepatectomy for malignant liver tumor
Masayasu Aikawa1, Mitsuo Miyazawa, Kojun Okamoto
1Gastrointestinal Center, Department of Surgery, Saitama Medical University International Medical Center, Saitama, 1397-1 Yamane, Hidaka, Saitama, 350-1298, Japan, aikawama@ybb.ne.jp.
Surgical Endoscopy
|August 29, 2013
Summary
Transthoracic approach (TH) is a viable option for liver tumors in difficult-to-access locations. This minimally invasive technique offers a safe alternative when laparoscopic surgery is challenging due to anatomical position and adhesions.
Area of Science:
- Hepatobiliary surgery
- Minimally invasive surgery
- Thoracic surgery
Background:
- Laparoscopic liver resection can be challenging for tumors in specific anatomical locations.
- The dome of segment VIII presents accessibility issues for standard laparoscopic approaches due to potential adhesions.
Observation:
- A 79-year-old male with a history of liver tumor resection underwent a transthoracic approach for a new tumor in segment VIII.
- The procedure involved thoracic access, diaphragm dissection, and laparoscopic ultrasound for tumor localization.
- Liver parenchyma was sealed and divided using specialized instruments, with specimen retrieval via a bag.
Findings:
- The transthoracic approach was successfully completed in 310 minutes with minimal blood loss (10 mL).
- The patient was discharged on postoperative day 4, indicating a favorable recovery.
- Despite the long operative time due to thoracic space constraints, the procedure was uneventful.
Implications:
- Transthoracic approach is recommended for liver lesions in dorsal segments VII/VIII, especially with significant adhesions.
- This technique expands the возможности of minimally invasive surgery for complex liver tumor resections.
- Further research may explore optimizing operative time and patient selection for transthoracic liver surgery.
