Segment 6: Laparoscopic Approach

Abstract

Totally laparoscopic liver resection (LLR), first described by Gagner et al. in 1992 [1], now appears to be safe and effective procedure to treat lesions located on left lateral (2 and 3), middle (4b), and anterior right (5, 6) segments. Tumors localized in the posterior and superior segments of the liver or masses requiring major liver resections (right hepatectomy, left hepatectomy, extended right or left hepatectomy) are still considered less frequent indications for the minimally invasive approach and should be reserved to centers with significant experience in laparoscopic liver surgery (LLS), open hepatic surgery, and intraoperative ultrasound (US) [2]. Indications for LLS, with particular reference to resection of segment 6 (S6), remain basically the same as in open surgery and, technical feasibility of S6 resection using a minimally invasive approach is increasing with surgeon skill [2]. On this basis, a liver lesion located on S6 should be routinely evaluated for LLR in high-volume centers.