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Feasible laparoscopic left trisectionectomy by Arantius' ligament approach (with video)
Koichiro Haruki1, Shinji Onda1, Jungo Yasuda1
1Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, The Jikei University School of Medicine, Tokyo, Japan.
Surgical Oncology
|October 1, 2021
Summary
The Arantius' ligament approach offers a feasible method for laparoscopic left trisectionectomy, a complex liver surgery. This technique aids in exposing critical hepatic veins, potentially improving outcomes for liver cancer patients.
Area of Science:
- Hepatobiliary surgery
- Minimally invasive surgical techniques
- Surgical oncology
Background:
- Laparoscopic trisectionectomy is a complex procedure associated with significant postoperative morbidity.
- The Arantius' ligament approach facilitates exposure of the middle hepatic vein, crucial for left trisectionectomy.
Observation:
- This video demonstrates a laparoscopic left trisectionectomy using the Arantius' ligament approach in a patient with intrahepatic cholangiocarcinoma.
- The procedure involved detailed steps including Glissonian pedicle control and parenchymal transection, with indocyanine green used for demarcation.
Findings:
- The surgery was completed in 294 minutes with 400g blood loss.
- The patient recovered well, with pathological examination confirming negative surgical margins for the cholangiocarcinoma.
Implications:
- The Arantius' ligament approach appears to be a viable and safe technique for performing laparoscopic left trisectionectomy.
- This method may help reduce the morbidity associated with this challenging liver resection.
