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Laparoscopic anatomic segmentectomy 8 using the outer-Laennec approach.

Kazuteru Monden1, Hiroshi Sadamori1, Masayoshi Hioki1

  • 1Departments of Surgery, Fukuyama City Hospital, Hiroshima, Japan.

Surgical Oncology
|September 20, 2020
PubMed
Summary

The outer-Laennec approach enables safe laparoscopic anatomic segmentectomy 8 for hepatocellular carcinoma (HCC). This technique preserves hepatic vein integrity, proving feasible and useful for standardizing this complex liver surgery.

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Area of Science:

  • Hepatobiliary Surgery
  • Minimally Invasive Procedures
  • Surgical Anatomy

Background:

  • Laparoscopic anatomic segmentectomy 8 is challenging due to the exposure of major hepatic veins.
  • The outer-Laennec approach, based on Laennec's capsule structure, was developed to enhance safety.
  • Laennec's capsule consists of hepatic and cardiac layers protecting the major hepatic vein.

Purpose of the Study:

  • To describe the application of the outer-Laennec approach for laparoscopic anatomic segmentectomy 8.
  • To evaluate the feasibility and utility of this technique in hepatocellular carcinoma (HCC) resection.

Main Methods:

  • Utilized the outer-Laennec approach to dissect between the hepatic Laennec's capsule and liver parenchyma.
  • Employed a cavitron ultrasonic surgical aspirator from the root towards the periphery to preserve the capsule.
Keywords:
Anatomic liver resectionLaennec's capsuleLaparoscopic liver resectionOuter-Laennec approach

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  • Completed parenchymal dissection via an S8 Glissonean pedicle dissection.

    • Main Results:

    • The procedure was completed in 296 minutes with minimal blood loss (10 mL).
    • The patient experienced an uneventful recovery and was discharged on postoperative day 5.
    • Pathological examination confirmed hepatocellular carcinoma (HCC) with negative margins.

    Conclusions:

    • The outer-Laennec approach is a feasible and valuable method for laparoscopic anatomic segmentectomy 8.
    • This technique aids in standardizing the safe execution of this complex liver surgery.