title: Atypical as well as anatomical liver resections are feasible by laparoendoscopic single-site surgery.
abstract: BACKGROUND
  Liver surgery was one of the last fields to be conquered by laparoscopy, which has become safe and effective, especially for left lateral sectionectomy (LLS) and limited peripheral resections. However, major hepatectomies remain challenging. Laparoendoscopic single-site (LESS) surgery is being employed for an increasing variety of surgical sites and indications.
  
  
  METHODS
  Three patients underwent LESS hepatectomy. A 36-year-old woman had LLS for a 38-mm adenoma, an 85-year-old woman an atypical resection of segment VI for a 12-mm hepatocellular carcinoma and a 41-year-old woman an atypical right anterior resection for a 9cm symptomatic FNH. Procedures were performed transperitoneally with a single-port device, via a 20-mm or 30-mm incision. Operative times were 110min for LLS, 100min for the atypical segment VI resection and 120min for the atypical right anterior liver resection. Blood loss was less than 50ml in the first two patients and 150ml in the third. Postoperative courses were uneventful. The first two patients were discharged on postoperative day 3 and the third on postoperative day 1.
  
  
  CONCLUSIONS
  To date, some case reports and series of LESS liver surgery have been published. We performed the reported hepatectomies after a considerable experience in laparoscopic hepatic surgery and after applying the LESS approach to other procedures. Our hepatectomy technique was not modified by the use of the single-port and results were very encouraging.
  
  
  CONCLUSIONS
  We believe that in selected patients, both peripheral resections and LLS are feasible by LESS surgery, with good intra-operative and post-operative results.
authors.affiliation: Department of General Surgery, Antoine-Béclère Hospital, AP-HP, 157 rue de la Porte de Trivaux, F-92140 Clamart cedex, France; University of Paris-Sud, Orsay F-91405, France.
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Tzanis
authors.affiliation: Department of General Surgery, Antoine-Béclère Hospital, AP-HP, 157 rue de la Porte de Trivaux, F-92140 Clamart cedex, France; University of Paris-Sud, Orsay F-91405, France.
authors.forename: Panagiotis
authors.initials: P
authors.lastname: Lainas
authors.affiliation: Department of General Surgery, Antoine-Béclère Hospital, AP-HP, 157 rue de la Porte de Trivaux, F-92140 Clamart cedex, France; University of Paris-Sud, Orsay F-91405, France.
authors.forename: Hadrien
authors.initials: H
authors.lastname: Tranchart
authors.affiliation: Department of General Surgery, Antoine-Béclère Hospital, AP-HP, 157 rue de la Porte de Trivaux, F-92140 Clamart cedex, France; University of Paris-Sud, Orsay F-91405, France.
authors.forename: Guillaume
authors.initials: G
authors.lastname: Pourcher
authors.affiliation: Department of General Surgery, Antoine-Béclère Hospital, AP-HP, 157 rue de la Porte de Trivaux, F-92140 Clamart cedex, France.
authors.forename: Niaz
authors.initials: N
authors.lastname: Devaquet
authors.affiliation: University of Paris-Sud, Orsay F-91405, France; Department of Gastroenterology, Antoine-Béclère Hospital, AP-HP, 157 rue de la Porte de Trivaux, F-92140 Clamart cedex, France.
authors.forename: Gabriel
authors.initials: G
authors.lastname: Perlemuter
authors.affiliation: University of Paris-Sud, Orsay F-91405, France; Department of Gastroenterology, Antoine-Béclère Hospital, AP-HP, 157 rue de la Porte de Trivaux, F-92140 Clamart cedex, France.
authors.forename: Sylvie
authors.initials: S
authors.lastname: Naveau
authors.affiliation: Department of General Surgery, Antoine-Béclère Hospital, AP-HP, 157 rue de la Porte de Trivaux, F-92140 Clamart cedex, France; University of Paris-Sud, Orsay F-91405, France. Electronic address: ibrahim.dagher@abc.aphp.fr.
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Dagher
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