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Hand-assisted Laparoscopic Repeat Hepatectomy for Secondary Liver Neoplasm
Ahmad Mahamid1,2, Yael Berger3,4, Nasser A Halim3,4
1Department of Surgery, Carmel Medical Center.
Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
|January 28, 2020
Summary
Hand-assisted laparoscopic repeat hepatectomy (HALRH) is a safe and feasible surgical option for liver resections, even with prior adhesions. This minimally invasive approach shows promising outcomes for patients requiring repeat liver surgery.
Area of Science:
- Surgical Oncology
- Minimally Invasive Surgery
- Hepatobiliary Surgery
Background:
- Hand-assisted laparoscopic surgery (HALS) is a common alternative to open surgery.
- HALS use in repeat liver resection is limited by adhesions.
- Assessing feasibility and safety of HALS for repeat hepatectomy is crucial.
Purpose of the Study:
- To evaluate the feasibility of hand-assisted laparoscopic repeat hepatectomy (HALRH).
- To assess the safety of HALRH in patients with prior liver surgery.
- To determine the efficacy of HALRH for liver tumor removal.
Main Methods:
- Retrospective analysis of HALRH cases from 2010-2017.
- Inclusion of 16 patients who underwent repeat hepatectomy.
- Data collection on surgical outcomes and patient demographics.
Main Results:
- HALRH demonstrated a low 6% conversion rate to open surgery.
- Achieved R0 resection in 88% of patients with median tumor size of 25mm.
- Reported no mortalities or major postoperative complications; median hospital stay was 7 days.
Conclusions:
- Hand-assisted laparoscopic repeat hepatectomy (HALRH) is a safe and feasible procedure.
- HALRH offers a viable minimally invasive option for repeat liver resections.
- Further evaluation in Enhanced Recovery After Surgery (ERAS) guidelines is recommended.
