title: Laparoscopic left lateral sectionectomy with the use of Habib 4X: technical aspects.
abstract: BACKGROUND
  Various techniques and energy-based devices have been used to minimize the blood loss during transection of the liver parenchyma laparoscopically. The laparoscopic Habib™ 4X sealer (Rita Medical Systems, Inc., Fremont, CA) is a promising device using bipolar radiofrequency energy. The purpose of the study was to test the safety and the efficiency of the device in laparoscopic left lateral sectionectomy.
  
  
  METHODS
  Five patients underwent laparoscopic left lateral sectionectomy using the laparoscopic Habib 4X in a period of 12 months. Indications for liver resection were hepatocellular carcinoma in 2 cirrhotic patients and colorectal cancer liver metastasis in 3 patients. Technical aspects were analyzed.
  
  
  RESULTS
  All the patients underwent formal laparoscopic left lateral sectionectomy. The Pringle maneuver was not applied in any of the patients. Mean operative time was 75 minutes (range, 60-90 minutes). Bleeding control along the transection line was satisfactory. No conversion to laparotomy was required. Operative blood loss was minimal. No blood transfusion was recorded. The postoperative period was uneventful. Median hospital stay was 3 days (range, 2-5 days). Histopathology revealed that the margins were disease free.
  
  
  CONCLUSIONS
  Laparoscopic left lateral segmentectomy with the use of Habib 4X proved safe and efficient. This technique may be an initial step for surgeons shifting to laparoscopic liver surgery provided they have previous experience in laparoscopic and liver surgery. Well-designed controlled randomized studies are needed in order to evaluate further the role of the device used in the present study in minimally invasive liver surgery.
authors.affiliation: Department of Surgery, University Hospital of Larissa, Larissa, Greece. zachadim@yahoo.com
authors.forename: Dimitris
authors.initials: D
authors.lastname: Zacharoulis
authors.forename: Eleni
authors.initials: E
authors.lastname: Sioka
authors.forename: George
authors.initials: G
authors.lastname: Tzovaras
authors.forename: Long R
authors.initials: LR
authors.lastname: Jiao
authors.forename: Nagy
authors.initials: N
authors.lastname: Habib
mesh_terms: D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000601:surgery*; D004867:Equipment Design; D005260:Female; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D020706:Laparoscopes; D010535:Laparoscopy; D008103:Liver Cirrhosis / Q000601:surgery*; D008113:Liver Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged