Application of devices for safe laparoscopic hepatectomy.
The continuing evolution of a variety of laparoscopic instrument and device has been gradually applied to the laparoscopic hepatectomy in many countries. Recent experience has persuaded us that there are great potential benefits derived from laparoscopic hepatectomy and much has been learned about patient selection, the grade of surgical difficulty with respect to tumor location, and the required instrumentation. Among these efforts, various ways of hepatic parenchymal transection with mechanical devices have been attempted and continuing to innovate to perform safe laparoscopic hepatectomy Important technologic developments and improved endoscopic procedures are being established equipment modifications. For safe laparoscopic hepatectomy, it is important to have all necessary equipment. The intraoperative laparoscopic ultrasonography, microwave coagulators, ultrasonic dissection, argon beam coagulators, laparoscopic coagulation shears, endolinear staplers and TissueLink monopolar sealer are essential. This procedure is in need that well experienced endoscopic surgeon and well-experienced liver surgeon should be collaborated in laparoscopic hepatectomy and the indications are strictly followed based upon the location and size of tumors. Finally critical determinant for success and safe laparoscopic hepatectomy is through familiarity with the relevant laparoscopic instruments and equipments. Laparoscopic hepatectomy is expected to develop further in the future as a new surgical instrument, equipment and method, which improves patients' quality of life.
Kaneko
H
H
Department of Surgery, Omori Hospital, Toho University School of Medicine, Tokyo, Japan. hironori@med.toho-u.ac.jp
Otsuka
Y
Y
Tsuchiya
M
M
Tamura
A
A
Katagiri
T
T
Yamazaki
K
K
Ann Surg. 2002 Jul;236(1):90-7
12131090
Am J Surg. 2005 Feb;189(2):190-4
15720988
Surg Today. 2001;31(7):569-74
11495149
Ann Surg. 2003 Nov;238(5):674-9
14578728
Arch Surg. 2000 Jul;135(7):854-9
10896382
Am J Surg. 2004 Feb;187(2):280-4
14769320
Surgery. 1996 Sep;120(3):468-75
8784399
Surg Endosc. 2003 Dec;17(12):1914-8
14574547
Surg Laparosc Endosc Percutan Tech. 2008 Feb;18(1):127-31
18288006
Ann Surg. 2000 Dec;232(6):753-62
11088070