Hand-assisted laparoscopic liver resection: lessons from an initial experience.
BACKGROUND
Recent innovations in laparoscopic instrumentation make routine resection of solid organs a clinical possibility.


OBJECTIVE
Hand-assisted laparoscopic liver resection is a safe and feasible procedure for solitary cancers requiring removal of 2 segments of liver or less.


METHODS
Eleven patients with liver tumors deemed technically resectable by laparoscopic techniques were subjected to laparoscopic evaluation and attempted hand-assisted laparoscopic resection between July 1998 and July 1999. During the same period, 230 patients underwent open liver resection.


METHODS
Tertiary care referral center for liver cancer.


METHODS
Success of laparoscopic resection, reasons for conversion to open liver resection, blood loss, tumor clearance margin, complications, and length of hospital stay.


RESULTS
Five patients underwent successful resection by the hand-assisted laparoscopic technique. Data from the 5 successful cases and the 6 aborted cases are presented to outline the issues and the lessons learned.


CONCLUSIONS
In selected patients, hand-assisted laparoscopic liver resection can be safely performed and might have potential advantages over traditional liver resection if the tumor is limited to the left lateral segment or is at the margins of the liver.
Fong
Y
Y
Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY 10021, USA.
Jarnagin
W
W
Conlon
K C
KC
DeMatteo
R
R
Dougherty
E
E
Blumgart
L H
LH
D000328:Adult; D000368:Aged; D000758:Anesthesia / Q000379:methods; D005069:Evaluation Studies as Topic; D005260:Female; D006498:Hepatectomy / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D020706:Laparoscopes; D010535:Laparoscopy / Q000379:methods*; D008113:Liver Neoplasms / Q000601:surgery; D008297:Male; D008875:Middle Aged; D013997:Time Factors; D016896:Treatment Outcome