title: Left-hand-assisted laparoscopic resection of hepatocellular carcinoma in an accessory liver.
abstract: We report a left-hand-assisted laparoscopic resection of hepatocellular carcinoma that developed in an accessory liver in a 47-year-old man. Preoperative assessment of the location of the tumor and the feeder vessels by combined selective angiography and computed tomography studies predicted the feasibility of laparoscopic procedures for complete removal of the tumor. In an attempt to avoid direct contact of the tumor capsule with rigid instruments during the operation, left-hand-assisted procedures were attempted. The encapsulated mass, 6 x 5 x 3 cm in size, was located on the posterior side of the left diaphragm, and a thin stalk between the tumor and the margin of the left lateral segment of the liver proper was recognized. Hand-assisted procedures ensured the complete mobilization of the lesion with an adequate margin, without any unexpected capsular tear. Left-hand-assisted laparoscopic procedures would be feasible for the easy and safe resection of localized hepatocellular carcinoma developing in an accessory liver.
authors.affiliation: Department of Surgery, Rinku General Medical Center, Izumisano Municipal Hospital, 2-23, Rinku Orai-Kita, Izumisano, Osaka 598-8577, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Iwase
authors.forename: T
authors.initials: T
authors.lastname: Takahashi
authors.forename: J
authors.initials: J
authors.lastname: Higaki
authors.forename: H E
authors.initials: HE
authors.lastname: Yoon
authors.forename: S
authors.initials: S
authors.lastname: Mikata
authors.forename: M
authors.initials: M
authors.lastname: Miyazaki
authors.forename: H
authors.initials: H
authors.lastname: Fujii
authors.forename: Y
authors.initials: Y
authors.lastname: Shirai
authors.forename: M
authors.initials: M
authors.lastname: Imakita
authors.forename: W
authors.initials: W
authors.lastname: Kamiike
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D007839:Functional Laterality; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008099:Liver / Q000002:abnormalities* / Q000000981:diagnostic imaging / Q000601:surgery*; D008113:Liver Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011859:Radiography