Completely laparoscopic nonanatomic hepatic resection using saline-cooled cautery and hydrodissection.

Completely laparoscopic nonanatomic hepatic resection using saline-cooled cautery and hydrodissection. Research Abstract Details 

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Completely laparoscopic nonanatomic hepatic resection using saline-cooled cautery and hydrodissection. Abstract Text:

Nicholas N Nissen,Navanjun Grewal,Joseph Lee,Atta Nawabi,Jeremy Korman,

The technical aspects of laparoscopic hepatic resection have evolved rapidly. The key to any approach is establishing a reliable method to prevent or control hemorrhage during parenchymal transection. Although combining a hand-assist technique with laparoscopy allows improved control of bleeding risk, this requires the addition of a hand-port incision. The development of novel devices that can be used to safely divide liver parenchyma laparoscopically may lessen the need for hand-assist. Here, we report a series of laparoscopic hepatic resections that were attempted without the use of hand-assistance (completely laparoscopic). Resections were performed using saline-cooled cautery (Tissue-Link Endohook) and/or hydrodissection (Erbe Helix Hydrojet). Fifteen laparoscopic hepatic resections were attempted by a single surgeon from 2002 to 2006. In each case, a nonanatomic, completely laparoscopic approach was attempted. Patients with lesions at the hepatic dome or those requiring lobectomy or hilar dissection were excluded. Fourteen of 15 cases (93%) were accomplished completely laparoscopically, while one patient required placement of a hand port. Resected tumors averaged 3.9 cm diameter. There were no bile leaks and no patient required transfusion. Average length of stay was 4.1 days (range 1-5). Complications included ileus (1) and atrial fibrillation (1). In six patients with malignancies, margins were negative and there have been no local or port recurrences. This report demonstrates the feasibility of completely laparoscopic hepatic resection using novel devices for parenchymal transaction. Hand-assist techniques remain useful as a salvage strategy or for larger resections.

Completely laparoscopic nonanatomic hepatic resection using saline-cooled cautery and hydrodissection. Publishing Authors By Initials

NN Nissen,N Grewal,J Lee,A Nawabi,J Korman,

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Completely laparoscopic nonanatomic hepatic resection using saline-cooled cautery and hydrodissection. Journal Published:

PUBLICATION TYPE: Journal Article

Journal: The American surgeon

VOLUME: 73

Page Numbers: 987-90

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ISSN: 0003-1348

DAY: 27

MONTH: Oct

YEAR: 2007

Completely laparoscopic nonanatomic hepatic resection using saline-cooled cautery and hydrodissection. Information

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LANGUAGE: eng

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AFFILIATION: Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, California 90048, USA. Nicholas.nissen@cshs.org

Country: United States

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MEDLINETA: Am Surg

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