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Annals of Surgical Oncology

, Volume 22, Supplement 3, pp 327–333 | Cite as

Laparoscopy-Specific Surgical Concepts for Hepatectomy Based on the Laparoscopic Caudal View: A Key to Reboot Surgeons’ Minds

  • Satoshi Ogiso
  • Takeo Nomi
  • Kenichiro Araki
  • Claudius Conrad
  • Etsuro Hatano
  • Shinji Uemoto
  • David Fuks
  • Brice GayetEmail author
Hepatobiliary Tumors

Abstract

Background

Despite diffusion of laparoscopic hepatectomy, the acquisition of necessary skills is not easy for open liver surgeons. Concepts and techniques have totally changed in laparoscopic hepatectomy compared with open hepatectomy, which is an underlying cause of a technical hurdle in laparoscopic hepatectomy. This study aimed to illustrate laparoscopy-specific concepts and techniques for hepatectomy.

Methods

Video footages of laparoscopic and open hepatectomies stored in the Institut Mutualiste Montsouris and Kyoto University were reviewed to define the differences in surgical view, surgical concept, and technical details, using left lateral sectionectomy (LLS) and right hepatectomy (RH) as representative examples.

Results

By comparison with open LLS and RH, laparoscopy-specific procedures were identified with regard to surgical view, parenchymal transection, available landmarks, and vascular dissection. By laparoscopy, the surgical field was constantly viewed and accessed from the caudal side to the cranial side. Similarly, the parenchyma was divided, and intrahepatic vessels were dissected in the same direction. Laparoscopy-specific landmarks were identified for both LLS and RH, behind the liver.

Conclusions

The concepts and techniques in laparoscopic hepatectomy are totally different from those of open hepatectomy because of the different surgical views. Understanding the laparoscopy-specific concepts and techniques would facilitate safe and efficient execution of laparoscopic hepatectomy.

Keywords

Middle Hepatic Vein Parenchymal Transection Laparoscopic Hepatectomy Left Hepatic Vein Left Lateral Sectionectomy 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Disclosure

None declared.

Supplementary material

Supplementary material 1 (MPG 3492 kb)

Supplementary material 2 (MPG 3594 kb)

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Copyright information

© Society of Surgical Oncology 2015

Authors and Affiliations

  • Satoshi Ogiso
    • 1
    • 2
  • Takeo Nomi
    • 1
    • 3
  • Kenichiro Araki
    • 1
    • 4
  • Claudius Conrad
    • 1
    • 5
  • Etsuro Hatano
    • 2
  • Shinji Uemoto
    • 2
  • David Fuks
    • 1
  • Brice Gayet
    • 1
    Email author
  1. 1.Department of Digestive Pathology, Institute Mutualiste MontsourisParis Descartes UniversityParisFrance
  2. 2.Division of Hepato-Biliary-Pancreatic Surgery and Transplantation, Department of Surgery, Graduate School of MedicineKyoto UniversityKyotoJapan
  3. 3.Department of SurgeryNara Medical UniversityNaraJapan
  4. 4.Department of General Surgical ScienceGunma University Graduate School of MedicineGunmaJapan
  5. 5.Department of Surgical OncologyThe University of Texas MD Anderson Cancer CenterHoustonUSA

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