Pure laparoscopic hepatectomy in semiprone position for right hepatic major resection.
BACKGROUND
Pure laparoscopic liver resection is technically difficult for tumors located in the dorsal anterior and posterior sectors. We have developed a maneuver to perform pure laparoscopic hepatectomy in the semiprone position which was developed for resecting tumors located in these areas.


METHODS
The medical records have been reviewed retrospectively in 30 patients who underwent laparoscopic liver resection in the semiprone position for carcinoma in the dorsal anterior or posterior sectors of the right liver between 2008 and 2011.


RESULTS
Seventeen liver tumors were primary liver tumors and 13 were colorectal metastases. Of the 30 patients, 11 (36.6 %) underwent major hepatectomy [right hemihepatectomy in 7 (23.3 %) and posterior sectionectomy in 4 (13.3 %)]. Anatomical minor resection, such as S6 or S7 segmentectomy, was performed in five patients (16.6 %). Five patients with liver metastasis underwent a simultaneous laparoscopic resection. There was no mortality, reoperation, or conversion to open procedures. There were no hepatectomy-related complications such as postoperative bleeding, bile leakage, or liver failure.


CONCLUSIONS
Pure laparoscopic hepatectomy in the semiprone position for tumors present in the dorsal anterior and posterior sectors is feasible and safe. This method expands the indications for laparoscopic liver resection for tumors.
Department of Surgery and Science, Graduate School of Medical Sciences, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan. t-ikeda@surg2.med.kyushu-u.ac.jp
Tetsuo
T
Ikeda
Yohei
Y
Mano
Kazutoyo
K
Morita
Naotaka
N
Hashimoto
Hirohito
H
Kayashima
Atsuro
A
Masuda
Toru
T
Ikegami
Tomoharu
T
Yoshizumi
Ken
K
Shirabe
Yoshihiko
Y
Maehara
D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis / Q000601:surgery*; D003952:Diagnostic Imaging; D005260:Female; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008113:Liver Neoplasms / Q000175:diagnosis / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D056888:Patient Positioning / Q000379:methods*; D016684:Prone Position; D012189:Retrospective Studies; D016896:Treatment Outcome