title: Laparoscopic unroofing of nonparasitic liver cysts within segments VII and VIII: technical considerations.
abstract: BACKGROUND
  The laparoscopic accessibility of congenital liver cysts located in the anterosuperior (VIII) and posterosuperior (VII) segments has been questioned for some time. In support of the laparoscopic approach, we here describe our minimally invasive technique in two patients with solitary congenital cysts located in the apex of liver segments VIII and VII, respectively.
  
  
  METHODS
  Both patients were placed in the inverted Y position. Four trocars were used, their position depending on the location of the cyst.
  
  
  RESULTS
  The segment VIII cyst was easily reached via this anterior approach, while the segment VII cyst required significant mobilization of the right liver lobe. In both cases a complete excision of the cystic roof was achieved using the harmonic scalpel. Without performing an omentoplasty no recurrences were observed after 20 and 28 months, respectively.
  
  
  CONCLUSIONS
  Solitary cysts located in segments VII and VIII of the liver can be safely treated by laparoscopic unroofing. Cyst recurrences may best be prevented by a complete excision of the cystic roof with an adjacent rim of hepatic parenchyma.
authors.affiliation: Department of Thoracic Surgery, University Hospital, Bern, Switzerland. thomas.weber@insel.ch
authors.forename: Thomas
authors.initials: T
authors.lastname: Weber
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Sendt
authors.forename: Johannes
authors.initials: J
authors.lastname: Scheele
mesh_terms: D000328:Adult; D003560:Cysts / Q000151:congenital / Q000601:surgery*; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008107:Liver Diseases / Q000151:congenital / Q000601:surgery*; D008875:Middle Aged; D016896:Treatment Outcome