Laparoscopic hepatectomy for benign liver tumors.
We describe our initial experience with videolaparoscopic hepatectomies. From November 1997 to May 1999, 6 female patients whose ages ranged from 36 to 71 years with hepatic benign tumors were submitted to laparoscopic hepatectomy. Three patients had hepatic adenomas, 1 non-parasitic cyst, 1 focal nodular hyperplasia and 1 hemangioma. The laparoscopy was performed under general anesthesia with a pneumoperitoneum of carbonic gas. The following were used: 0 degree and 30 degrees optics, 5, 10 e 12-mm trochars, a ring forceps, dissecting forceps, simple grasping forceps, curved scissors, mono- and bipolar cautery, endoscopic clip and vascular stapler. No ultrasonic scalpel or argonium coagulation were used. The surgical specimens were removed through a Pfannenstiel incision around 4-5 cm long, for a better anatomopathological evaluation. The surgical time ranged from 3 hours to 4 hours and 30 minutes. One patient had a prolonged ileus during the immediate postoperative period. Only a single patient had an abdominal drain. The time of hospitalization ranged from 2 to 7 days. No complications were observed in relation to the pneumoperitoneum. No deaths occurred in this series. In this way, laparoscopic hepatectomy may be an alternative approach in carefully selected patients.
Kalil
Antonio Nocchi
AN
Department of Surgery of Fundação Faculdade Federal de Ciências Médicas de Porto Alegre and Hospital Santa Rita, Santa Casa de Porto Alegre, Brazil. ankalil.voy@terra.com.br
Mastalir
Eduardo Touguinha
ET
D000236:Adenoma / Q000601:surgery; D000328:Adult; D000368:Aged; D005260:Female; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy; D007902:Length of Stay; D008113:Liver Neoplasms / Q000601:surgery*; D008875:Middle Aged; D011028:Pneumoperitoneum, Artificial; D012189:Retrospective Studies; D016896:Treatment Outcome