title: Totally laparoscopic right hepatectomy.
abstract: BACKGROUND
  Since the first laparoscopic cholecystectomy was performed in 1987, the surgical applications of laparoscopy have grown to involve most areas of general surgery. Until recently, however, major liver surgery remained outside of the scope of minimally invasive surgery. Building on advances in laparoscopic equipment, techniques, and ongoing experience in hepatic surgery, major liver resection has been performed laparoscopically in some select centers. At our institute, a safe and standardized approach to minimally invasive major hepatectomy has been developed. This article illustrates the relevant technical maneuvers in the performance of a totally laparoscopic right hepatectomy. Common pitfalls and areas of concern are discussed.
  
  
  METHODS
  A detailed description of a standardized procedure is presented. The technique was developed from a single-institution experience of 41 laparoscopic right hepatectomies performed in a tertiary care referral center for laparoscopic digestive surgery. The prevention of bleeding and gas embolism are discussed.
  
  
  CONCLUSIONS
  The laparoscopic right hepatectomy is feasible and safe if the appropriate expertise and equipment are available. In selected patients, this new approach can be proposed by a surgeon experienced in laparoscopic and hepatic surgery as an alternative to conventional open liver resection.
authors.affiliation: Institut Mutualiste Montsouris, IMM 42 Bd Jourdan, 75014 Paris, France. brice.gayet@imm.fr
authors.forename: Brice
authors.initials: B
authors.lastname: Gayet
authors.forename: Davide
authors.initials: D
authors.lastname: Cavaliere
authors.forename: Eric
authors.initials: E
authors.lastname: Vibert
authors.forename: Thierry
authors.initials: T
authors.lastname: Perniceni
authors.forename: Hugues
authors.initials: H
authors.lastname: Levard
authors.forename: Christine
authors.initials: C
authors.lastname: Denet
authors.forename: Christos
authors.initials: C
authors.lastname: Christidis
authors.forename: Antoine
authors.initials: A
authors.lastname: Blain
authors.forename: Frédéric
authors.initials: F
authors.lastname: Mal
mesh_terms: D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy