Jove
Visualize
Contact Us
JoVE
x logofacebook logolinkedin logoyoutube logo
ABOUT JoVE
OverviewLeadershipBlogJoVE Help Center
AUTHORS
Publishing ProcessEditorial BoardScope & PoliciesPeer ReviewFAQSubmit
LIBRARIANS
TestimonialsSubscriptionsAccessResourcesLibrary Advisory BoardFAQ
RESEARCH
JoVE JournalMethods CollectionsJoVE Encyclopedia of ExperimentsArchive
EDUCATION
JoVE CoreJoVE BusinessJoVE Science EducationJoVE Lab ManualFaculty Resource CenterFaculty Site
Terms & Conditions of Use
Privacy Policy
Policies

Related Concept Videos

You might also read

Related Articles

Articles linked to this work by shared authors, journal, and citation graph.

Sort by
Same author

Robotic liver resection for non colorectal metastases: how to deal with it. A multi-center case series.

European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology·2026
Same author

Comprehensive genetic analysis in biliary tract cancer: a prospective single-center experience.

ESMO gastrointestinal oncology·2026
Same author

Adequate lymphadenectomy and adjuvant capecitabine warrant survival benefit in gallbladder cancer.

European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology·2025
Same author

Impact of CT-Assessed Liver Steatosis in Hepatic Regeneration and Surgical Outcome After Liver Venous Deprivation.

Cardiovascular and interventional radiology·2025
Same author

ASO Author Reflections: Hypertrophic Techniques Have an Impact on the Complexity and Outcomes of Minimally Invasive Major Hepatectomies.

Annals of surgical oncology·2024
Same author

The "double-fired" gastro-jejunostomy as a form of improved efficiency during Whipple procedure.

HPB : the official journal of the International Hepato Pancreato Biliary Association·2024
Same journal

ASO Author Reflections: Does the Axilla Still Matter? Rethinking Nodal Staging in the Era of CDK4/6 Inhibition.

Annals of surgical oncology·2026
Same journal

Omission of Axillary Surgery in Patients with Invasive Lobular Carcinoma of the Breast: Rates of Nodal Involvement in Clinically Node Negative Patients and Impact on Recurrence in a Single Institution Analysis.

Annals of surgical oncology·2026
Same journal

Is Mastectomy Necessary in Patients with Occult Breast Cancer and Advanced (N2/N3) Nodal Disease?

Annals of surgical oncology·2026
Same journal

Expanding Eligibility for Targeted Axillary Dissection.

Annals of surgical oncology·2026
Same journal

ASO Author Reflections: Reconsidering Surgical Indications for Clinical T4 Non-Small Cell Lung Cancer in the TNM 9th Edition Era.

Annals of surgical oncology·2026
Same journal

Potential Impact of Sentinel Lymph Node Biopsy Omission on Adjuvant Treatment Decisions in Low-Risk Breast Cancer: A Regional Multicenter 775 Patient Review of Current Practice in the United Kingdom.

Annals of surgical oncology·2026
See all related articles

Related Experiment Video

Updated: Nov 16, 2025

Implementation of a Real-Time Psychosis Risk Detection and Alerting System Based on Electronic Health Records using CogStack
07:31

Implementation of a Real-Time Psychosis Risk Detection and Alerting System Based on Electronic Health Records using CogStack

Published on: May 15, 2020

7.4K

The SMART-ALPPS Protocol: Strategy to Minimize ALPPS Risks by Targeting Invasiveness.

G Fiorentini1,2, F Ratti3, F Cipriani3

  • 1Hepatobiliary Surgery Division, IRCCS San Raffaele Hospital, Milan, Italy. fiorentini.guido@hsr.it.

Annals of Surgical Oncology
|February 24, 2021
PubMed
Summary
This summary is machine-generated.

Laparoscopic associated liver partition and portal vein ligation for staged hepatectomy (ALPPS) minimizes invasiveness. A SMART protocol assessing liver function and volume reduces risks, enabling safe patient discharge.

More Related Videos

A Machine Learning Approach to Design an Efficient Selective Screening of Mild Cognitive Impairment
12:18

A Machine Learning Approach to Design an Efficient Selective Screening of Mild Cognitive Impairment

Published on: January 11, 2020

7.7K
Machine Learning Algorithms for Early Detection of Bone Metastases in an Experimental Rat Model
07:15

Machine Learning Algorithms for Early Detection of Bone Metastases in an Experimental Rat Model

Published on: August 16, 2020

7.2K

Related Experiment Videos

Last Updated: Nov 16, 2025

Implementation of a Real-Time Psychosis Risk Detection and Alerting System Based on Electronic Health Records using CogStack
07:31

Implementation of a Real-Time Psychosis Risk Detection and Alerting System Based on Electronic Health Records using CogStack

Published on: May 15, 2020

7.4K
A Machine Learning Approach to Design an Efficient Selective Screening of Mild Cognitive Impairment
12:18

A Machine Learning Approach to Design an Efficient Selective Screening of Mild Cognitive Impairment

Published on: January 11, 2020

7.7K
Machine Learning Algorithms for Early Detection of Bone Metastases in an Experimental Rat Model
07:15

Machine Learning Algorithms for Early Detection of Bone Metastases in an Experimental Rat Model

Published on: August 16, 2020

7.2K

Area of Science:

  • Hepatobiliary Surgery
  • Minimally Invasive Surgery
  • Surgical Oncology

Background:

  • Laparoscopic liver resections are expanding, overcoming technical challenges.
  • Associated Liver Partition and Portal Vein Ligation for Staged Hepatectomy (ALPPS) is highly invasive but can be performed laparoscopically.
  • Minimally invasive approaches reduce the biological impact of major liver procedures.

Purpose of the Study:

  • To provide technical insights for performing laparoscopic ALPPS.
  • To present a protocol (SMART) for minimizing risks associated with ALPPS.
  • To detail a two-stage approach for laparoscopic ALPPS.

Main Methods:

  • Stage 1 involves partial liver transection, avoiding portal ligation and adhesions, followed by embolization.
  • Post-embolization assessment of future remnant liver (FRL) volume and function using imaging and scintigraphy.
  • Stage 2 is a laparoscopic right hepatectomy performed after FRL assessment.

Main Results:

  • Laparoscopic ALPPS was completed without conversion to open surgery.
  • Stage 1 operative time was 100 minutes with 50 ml blood loss; Stage 2 was 300 minutes with 300 ml blood loss.
  • The patient had an uneventful recovery and was discharged on postoperative day 6.

Conclusions:

  • A perioperative protocol assessing FRL volume and function is crucial.
  • Targeting invasiveness in ALPPS minimizes risks of liver failure.
  • Laparoscopic ALPPS can be safely performed with careful risk management.