Laparoscopic Right Posterior Sectionectomy for Malignant Lesions: An Anatomic Approach

Area of Science:

• Hepatobiliary Surgery
• Minimally Invasive Surgery
• Surgical Oncology

Background:

• Laparoscopic hepatectomy is indicated for anterolateral liver tumors.
• Resection of right posterior section tumors laparoscopically is technically difficult.

Purpose of the Study:

• To present a case series on laparoscopic right posterior sectionectomy.
• To evaluate the feasibility and outcomes of this procedure.

Main Methods:

• Prospective data collection on patient demographics, tumor characteristics, operative details, and outcomes.
• Analysis of 13 cases of laparoscopic right posterior sectionectomy performed between May 2010 and May 2014.

Main Results:

• 13 laparoscopic right posterior sectionectomies were performed for hepatocellular carcinoma (11) and colorectal liver metastasis (2).
• Median operative time was 381 minutes with median blood loss of 1500 mL; significant bleeding occurred in early cases.
• Median tumor size was 3.7 cm with a 8.7 mm resection margin; no postoperative mortality and a median hospital stay of 7 days.

Conclusions:

• Laparoscopic right posterior sectionectomy is technically demanding.
• Meticulous inflow and outflow control are critical for anatomical resection.
• These surgical principles are paramount even with advancements in laparoscopic liver surgery.