Laparoscopy-assisted hepatectomy using the Endoclose: a case report.
Hemostasis of a resected stump of liver is extremely difficult in laparoscopic hepatectomy. Although Pringle's maneuver, which is a total clamping of the hepatoduodenal ligament, is a useful technique, it is often difficult in laparoscopic circumstances. Moreover, total inflow occlusion leads to postoperative liver damage. Therefore, the local bleeding method is ideal. The Endoclose, a device for port site closure, is formed from an outer sheath and an inner needle with a notch to load the suture. The Endoclose is loaded with a suture and passed through the liver. The suture is left under the liver, and the device is removed. Next, the suture carrier is passed through the liver at an appropriate distance, and the suture is regrasped by this suture carrier and brought out of the liver. Herein we report a case in which a new bleeding control method using Endoclose was introduced for laparoscopy-assisted hepatectomy.
Maehara
S
S
Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-Ku, Fukuoka 812-8582, Japan. shinm@surg2.med.kyushu-u.ac.jp
Harimoto
N
N
Tsujita
E
E
Rikimaru
T
T
Yamashita
Y
Y
Tanaka
S
S
Adachi
E
E
Shirabe
K
K
Shimada
M
M
Sugimachi
K
K
D000368:Aged; D016558:Hemostasis, Endoscopic / Q000295:instrumentation / Q000379:methods; D006498:Hepatectomy / Q000295:instrumentation* / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008099:Liver / Q000098:blood supply / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D008113:Liver Neoplasms / Q000098:blood supply / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000601:surgery; D008297:Male; D013536:Suture Techniques; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography