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Updated: Apr 18, 2026
Modified Laparoscopic Anatomic Hepatectomy: Two-Surgeon Technique Combined with the Simple Extracorporeal Pringle Maneuver
Published on: June 16, 2023
Pure laparoscopic hepatectomy as repeat surgery and repeat hepatectomy.
Masashi Isetani1, Zenichi Morise1, Norihiko Kawabe1
1Masashi Isetani, Zenichi Morise, Norihiko Kawabe, Hirokazu Tomishige, Hidetoshi Nagata, Jin Kawase, Satoshi Arakawa, Department of Surgery, Fujita Health University School of Medicine, Banbuntane Houtokukai Hospital, Aichi, Nagoya 454-8509, Japan.
Laparoscopic hepatectomy (LH) is safe for patients with prior upper abdominal surgery or repeat liver resections. This minimally invasive approach shows comparable outcomes to those without prior abdominal interventions.
Area of Science:
- Hepatobiliary surgery
- Minimally invasive surgery
- Surgical oncology
Background:
- Laparoscopic hepatectomy (LH) offers potential benefits for liver tumor resection.
- Patient selection for LH can be challenging, especially in those with prior abdominal surgeries.
- Assessing the safety and efficacy of LH in these complex cases is crucial.
Purpose of the Study:
- To evaluate the clinical outcomes of laparoscopic hepatectomy (LH) in patients with a history of upper abdominal surgery.
- To compare perioperative results in patients undergoing LH with or without prior abdominal interventions.
- To determine the feasibility and safety of repeat hepatectomy using a laparoscopic approach.
Main Methods:
- Retrospective comparison of 80 patients undergoing LH.
- Group 1: 22 patients with prior upper abdominal surgery (including previous hepatectomy, pancreatectomy, gastrectomy, etc.).
- Group 2: 58 patients without prior upper abdominal surgery. Perioperative data (operative time, blood loss, hospital stay, morbidity) were analyzed.
Main Results:
- Prior surgery led to adhesions in 18/22 patients, but no conversions to open surgery were needed.
- No statistically significant differences in operative time, blood loss, or postoperative stay were observed between groups.
- Complication rates were low and comparable, with 1 case in the prior surgery group versus 5 in the no-prior-surgery group.
Conclusions:
- Laparoscopic hepatectomy (LH) is a feasible and safe procedure for patients with a history of upper abdominal surgery.
- Repeat hepatectomy via laparoscopy is also safe and effective in selected patients.
- Minimally invasive liver resection can be successfully performed in complex patient populations.
