Laparoscopic Hepatic Transection Using Microwave

  • Yuichiro Otsuka
  • Hironori KanekoEmail author


With recent advances in the techniques and devices used in laparoscopic surgery, the number of surgical teams attempting laparoscopic liver resection has been gradually increasing. The critical determinant for safe laparoscopic hepatectomy is thorough familiarity with laparoscopic instruments and equipment for maintenance of hemostasis. Thermal precoagulation of the liver parenchymal transection plane performed by using microwave energy helps reduce blood loss during parenchymal transection, especially in patients with liver cirrhosis. Currently, 5- to 10-mm-diameter 45° flexible-angle needle probes (Endo-Angle Probe®) are available in minimally invasive surgery including pure endoscopic, and hand- or endoscopy-assisted liver resections. Microwave also allows simultaneous tumor ablation with liver resection, even during laparoscopic procedures for multiple liver tumors. Although laparoscopic liver resection requires careful selection of patients and instrumentation, use of microwave tissue coagulation could contribute to safe laparoscopic liver surgery.


Laparoscopic liver resection Microwave Liver transection Liver tumor Minimally invasive liver resection 

Supplementary material

ESM 1 (VIDEO 313590 KB)


  1. 1.
    Buell JF, Cherqui D, Geller DA et al. (2009) The international position on laparoscopic liver surgery: the Louisville Statement, 2008. Ann Surg 250:825–830PubMedCrossRefGoogle Scholar
  2. 2.
    Kaneko H, Otsuka Y, Tsuchiya M et al. (2008) Application of devices for safe laparoscopic hepatectomy. HPB 10:219–224PubMedCentralPubMedCrossRefGoogle Scholar
  3. 3.
    Kaneko H, Tsuchiya M, Otsuka Y et al. (2009) Laparoscopic hepatectomy for hepatocellular carcinoma in cirrhotic patients. J Hepatobiliary Pancreat Surg 16:433–438PubMedCrossRefGoogle Scholar
  4. 4.
    Koffron A, Auffenberg G, Kung R et al. (2007) Evaluation of 300 minimally invasive liver resections at a single institution: less is more. Ann Surg 246:385–394PubMedCrossRefGoogle Scholar
  5. 5.
    Nitta H, Sasaki A, Fujita T et al. (2010) Laparoscopy-assisted major liver resections employing a hanging technique: the original procedure. Ann Surg 251:450–453PubMedCrossRefGoogle Scholar
  6. 6.
    Murakami M, Aoki T, Kato T (2011) Video-assisted thoracoscopic surgery: hepatectomy for liver neoplasm. World J Surg 35:1050–1054PubMedCrossRefGoogle Scholar
  7. 7.
    Tabuse K, Katsumi M, Kobayashi Y et al. (1985) Microwave surgery: hepatectomy using a microwave tissue coagulator. World J Surg 9:136–143PubMedCrossRefGoogle Scholar
  8. 8.
    Ryu M, Watanabe K, Yamamoto H (1998) Hepatectomy with microwave tissue coagulation for hepatocellular carcinoma. J Hep Bil Pancr Surg 5:184–191CrossRefGoogle Scholar
  9. 9.
    Satoi S, Kamiyama Y, Matsui Y et al. (2005) Clinical outcome of 214 liver resections using microwave tissue coagulation. Hepatogastroenterology 52:1180–1185PubMedGoogle Scholar
  10. 10.
    Christian DJ, Khithani A, Jeyarajah DR (2011) Making liver transection even safer: a novel use of microwave technology. Am Surg 77:417–421PubMedGoogle Scholar
  11. 11.
    Kaneko H, Takagi S, Shiba S (1996) Laparoscopic partial hepatectomy and left lateral segmentectomy: technique and results of a clinical series. Surgery 120:468–475PubMedCrossRefGoogle Scholar
  12. 12.
    Reuter PN, Robert CG, Martin II (2009) Microwave energy as a precoagulative device to assist in hepatic resection. Ann Surg Oncol 16:3057–3063PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Italia 2012

Authors and Affiliations

  1. 1.Department of Surgery (Omori)Toho University Faculty of MedicineOtakuJapan

Personalised recommendations