Role of intercostal trocars on laparoscopic liver resection for tumors in segments 7 and 8.
Performing laparoscopic liver resection for lesions located in segment 7 and 8 is technically difficult, as the operative field is far from the conventional trocar site, and the liver impedes free motion of the laparoscopic instrument. Inserting the port through the intercostal space (ICS) may facilitate liver resection for these lesions. From January 2012 to July 2013, five patients (four men and one woman) underwent laparoscopic S7 or 8 segmentectomy for liver metastasis and hepatocellular carcinoma (HCC). Ports were inserted at the 7th and 9th ICS, respectively, in addition to conventional abdominal ports. The mean age was 58 ± 10 (45-74) years; operation time, 197 ± 68 (110-300) minutes; blood loss, 161 ± 138 (40-320) ml; and length of hospital stay, 7 ± 3 (4-12) days. Pathologic findings revealed three, one, and one case(s) of colon cancer metastasis, breast cancer metastasis, and HCC, respectively. The mean tumor size and tumor-free margin were 2.2 ± 1.1 cm and 5.8 ± 1.9 mm, respectively. There were no postoperative complications. Laparoscopic liver resection using intercostal trocars could be a useful method for tumors located in segments 7 and 8 of the liver in selected patients.
Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, 300 Gumi-dong, Bundang-gu, Seongnam-si, Gyeonggi-do, 463-707, Korea. hanhs@snubh.org.
Woohyung
W
Lee
Ho-Seong
HS
Han
Yoo-Seok
YS
Yoon
Jai Young
JY
Cho
YoungRok
Y
Choi
Hong Kyung
HK
Shin
D000368:Aged; D001943:Breast Neoplasms / Q000473:pathology; D006528:Carcinoma, Hepatocellular / Q000601:surgery; D003110:Colonic Neoplasms / Q000473:pathology; D005260:Female; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy; D008113:Liver Neoplasms / Q000473:pathology / Q000556:secondary / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D013525:Surgical Instruments
Intercostal trocar; Laparoscopic liver resection; Posterosuperior liver resection