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Laparoscopic Segmentectomy IV Using Hepatic Round Ligament Approach Combined with Fluorescent Negative Staining
Kejie Zheng1, Diao He2, Anque Liao3
1Department of Liver Surgery, Liver Transplantation Center, West China Hospital of Sichuan University, Chengdu, Sichuan Province, China.
Annals of Surgical Oncology
|January 7, 2022
Summary
Laparoscopic segmentectomy IV for hepatocellular carcinoma (HCC) using a round ligament approach and fluorescent negative staining is a safe and effective surgical option. This technique preserves liver function and offers a viable alternative to traditional hemihepatectomy for HCC treatment.
Area of Science:
- Hepatobiliary surgery
- Minimally invasive surgical techniques
- Hepatocellular carcinoma (HCC) treatment
Background:
- Laparoscopic segmentectomy is a viable alternative to hemihepatectomy for hepatocellular carcinoma (HCC), maximizing functional hepatic reserve and enabling future re-hepatectomy.
- This study presents a video demonstration of laparoscopic segmentectomy IV for HCC utilizing a hepatic round ligament approach combined with fluorescent negative staining.
Observation:
- A 44-year-old male with chronic hepatitis B virus (HBV) infection underwent laparoscopic segmentectomy IV for a single HCC.
- The procedure involved lowering the hilar plate, dissecting Glisson's pedicles to segment IV, and parenchyma transection along the falciform ligament.
- Fluorescent negative staining guided parenchyma transection along the negative fluorescence region to expose the middle hepatic vein (MHV).
Findings:
- The surgery was completed in 190 minutes with 80 mL blood loss.
- Histopathology confirmed a 2.5 cm solitary HCC with negative surgical margins and no microvascular invasion.
- The patient experienced an uneventful recovery and was discharged on postoperative day 5.
Implications:
- The round ligament approach combined with fluorescent negative staining is a feasible and effective technique for laparoscopic anatomic segmentectomy IV.
- This minimally invasive approach offers a promising alternative for HCC treatment, potentially improving patient outcomes and liver function preservation.
