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Laennec's approach for laparoscopic anatomic hepatectomy based on Laennec's capsule.
Yue Hu1,2, Jiong Shi2, Shaohe Wang3
1Biobank of Nanjing Drum Tower Hospital, The Affiliated Drum Tower Hospital, School of Medicine, Nanjing University, Nanjing, Jiangsu Province, People's Republic of China.
BMC Gastroenterology
|November 23, 2019
Summary
A novel Laennec's approach for laparoscopic anatomic hepatectomy (LAH) standardizes liver resection. This technique utilizes Laennec's capsule as a landmark, improving safety and efficiency in complex liver surgeries.
Area of Science:
- Hepatobiliary Surgery
- Minimally Invasive Surgery
- Surgical Anatomy
Background:
- Standardized approaches for isolating Glissonean pedicles and hepatic veins in anatomical hepatectomy are lacking.
- Laparoscopic anatomic hepatectomy (LAH) requires precise identification of surgical landmarks.
- Laennec's capsule offers a potential anatomical landmark for liver surgery.
Purpose of the Study:
- To introduce and evaluate the novel Laennec's approach for laparoscopic anatomic hepatectomy (LAH).
- To demonstrate how the natural gap around Laennec's capsule aids in standardizing LAH.
- To establish Laennec's capsule as a reliable landmark for safe and effective laparoscopic liver resection.
Main Methods:
- An observable clinical trial involving 84 patients undergoing LAH for liver diseases.
- Application of Laennec's approach, utilizing Laennec's capsule as the primary surgical landmark.
- Histological analysis (H&E, resorcinol-fuchsin staining, immunohistochemistry) of liver tissues surrounding key anatomical structures.
Main Results:
- Histological examination confirmed Laennec's capsule encapsulates the liver, independent of adjacent tissues and vessels.
- A consistent natural gap was identified between Laennec's capsule and surrounding tissues.
- Laennec's capsule effectively guided pedicle isolation, liver mobilization, and the Hanging maneuver in 84 LAH cases.
- Average operative time was 277.23 minutes, with a mean hospital stay of 9.8 days.
Conclusions:
- Laennec's approach, centered on Laennec's capsule, standardizes the surgical technique for LAH.
- This novel method facilitates safe and efficient liver resection through laparoscopy.
- The identified natural gap enhances the reliability and reproducibility of LAH.
