Navigation Guidance Using Polyglycolic Acid Felt in Pure Laparoscopic Partial Hepatectomy

Area of Science:

• Hepatobiliary surgery
• Minimally invasive surgery
• Surgical navigation technologies

Background:

• Accurate determination of the tumor blood flow drainage area (TBF-D area) and tumor is crucial for pure laparoscopic partial hepatectomy (PLH).
• Current navigation technologies for PLH are still under development and not widely applicable in clinical practice.
• A novel method using absorbable polyglycolic acid (PGA) felt as a navigation guide for PLH was developed to address these challenges.

Observation:

• A custom-shaped PGA felt was applied to the liver surface as an intraoperative guide for PLH.
• The PGA felt was aligned with the tumor's center, and the resection line was marked using monopolar electrocautery.
• Following PGA felt removal, PLH was performed along the marked line.

Findings:

• The technique allowed for successful and accurate resection of both the tumor and the TBF-D area in PLH.
• Surgical margins were confirmed to be adequate, with complete tumor and TBF-D area resection.
• Comparison with preoperative computed tomography angiography confirmed successful resection.

Implications:

• This new PGA felt navigation technique is easy to use and safe for PLH.
• It enables accurate and appropriate resection of tumors and their surrounding drainage areas.
• This method has the potential to improve surgical precision and outcomes in laparoscopic liver surgery.