title: Single incision laparoscopic hepatectomy: Advances in laparoscopic liver surgery.
abstract: BACKGROUND
  Laparoscopic liver surgery is now an established practice in many institutions. It is a safe and feasible approach in experienced hands. Single incision laparoscopic surgery (SILS) has been performed for cholecystectomies, nephrectomies, splenectomies and obesity surgery. However, the use of SILS in liver surgery has been rarely reported. We report our initial experience in seven patients on single incision laparoscopic hepatectomy (SILH).
  
  
  METHODS
  From October 2010 to September 2012, seven patients underwent single-incision laparoscopic liver surgery. The abdomen was approached through a 25 mm periumbilical incision. No supplemental ports were required. The liver was transected using a combination of LigaSure™ (Covidien-Valleylab. Boulder. USA), Harmonic Scalpel and Ligaclips (Ethicon Endo-Surgery, Inc.).
  
  
  RESULTS
  Liver resection was successfully completed for the seven patients. The procedures consisted of two partial resections of segment three, two partial resections of segment five and three partial resections of segment six. The mean operative time was 98.3 min (range: 60-150 min) and the mean estimated blood loss was 57 ml (range: 25-150 ml). The postoperative courses were uneventful and the mean hospital stay was 5.1 days (range: 1-13 days). Pathology identified three benign and four malignant liver tumours with clear margins.
  
  
  CONCLUSIONS
  SILH is a technically feasible and safe approach for wedge resections of the liver without oncological compromise and with favourable cosmetic results. This surgical technique requires relatively advanced laparoscopic skills. Further studies are needed to determine the potential advantages of this technique, apart from the better cosmetic result, compared to the conventional laparoscopic approach.
authors: Digestive, Hepato-Bilio-Pancreatic Surgical and Hepatic Transplantation Service, Henri Mondor Hospital, Creteil, France.
authors: Claude
authors: C
authors: Tayar
authors: Digestive, Hepato-Bilio-Pancreatic Surgical and Hepatic Transplantation Service, Henri Mondor Hospital, Creteil, France.
authors: Tayar
authors: T
authors: Claude
authors: Digestive, Hepato-Bilio-Pancreatic Surgical and Hepatic Transplantation Service, Henri Mondor Hospital, Creteil, France.
authors: Daren
authors: D
authors: Subar
authors: Digestive, Hepato-Bilio-Pancreatic Surgical and Hepatic Transplantation Service, Henri Mondor Hospital, Creteil, France ; Department of General and Hepato-Pancreato-Biliary Surgery, Blackburn Royal Hospital, Blackburn, Lancashire, United Kingdom.
authors: Subar
authors: S
authors: Daren
authors: Digestive, Hepato-Bilio-Pancreatic Surgical and Hepatic Transplantation Service, Henri Mondor Hospital, Creteil, France.
authors: Chady
authors: C
authors: Salloum
authors: Digestive, Hepato-Bilio-Pancreatic Surgical and Hepatic Transplantation Service, Henri Mondor Hospital, Creteil, France.
authors: Salloum
authors: S
authors: Chady
authors: Digestive, Hepato-Bilio-Pancreatic Surgical and Hepatic Transplantation Service, Henri Mondor Hospital, Creteil, France.
authors: Alexandre
authors: A
authors: Malek
authors: Digestive, Hepato-Bilio-Pancreatic Surgical and Hepatic Transplantation Service, Henri Mondor Hospital, Creteil, France.
authors: Malek
authors: M
authors: Alexandre
authors: Digestive, Hepato-Bilio-Pancreatic Surgical and Hepatic Transplantation Service, Henri Mondor Hospital, Creteil, France.
authors: Alexis
authors: A
authors: Laurent
authors: Digestive, Hepato-Bilio-Pancreatic Surgical and Hepatic Transplantation Service, Henri Mondor Hospital, Creteil, France.
authors: Laurent
authors: L
authors: Alexis
authors: Digestive, Hepato-Bilio-Pancreatic Surgical and Hepatic Transplantation Service, Henri Mondor Hospital, Creteil, France.
authors: Daniel
authors: D
authors: Azoulay
authors: Digestive, Hepato-Bilio-Pancreatic Surgical and Hepatic Transplantation Service, Henri Mondor Hospital, Creteil, France.
authors: Azoulay
authors: A
authors: Daniel
keywords: Hepatectomy; laparoscopic liver resection; single incision laparoscopic hepatectomy (SILH); single incision laparoscopic surgery (SILS)