title: Rationale and surgical technique of laparoscopic left lateral sectionectomy using endoscopic staples.
abstract: OBJECTIVE
  Laparoscopic left lateral sectionectomy (LLLS) has been widely accepted due to benefits of minimally invasive surgery. Some surgeons prefer to isolate glissonian pedicles to segments II and III and to control individual pedicles with surgical clips, whereas opt like to control glissonian pedicles simultaneously using endoscopic stapling devices. The aim of this study was to find the rationale of LLLS using endoscopic staples.
  
  
  METHODS
  We retrospectively analyzed and compared the clinical outcomes (operation time, drainage length, transfusion, hospital stay, and complication rate) of 35 patients that underwent LLLS between April 2004 and February 2012. Patients were dichotomized by surgical technique based on whether glissonian pedicles were isolated and controlled (the individual group, n = 21) or controlled using endoscopic staples at once (the batch group, n = 14).
  
  
  RESULTS
  Mean operation time was 265.3 ± 21.3 minutes (mean ± standard deviation) in the individual group and 170 ± 22.9 minutes in the batch group. Operation time in the batch group was significantly shorter than the individual group (P = 0.007). Mean drainage length was 4.8 ± 1.6 and 2.6 ± 1.5 days in the individual and the batch group. There was significantly shorter in the batch group, also (P = 0.006). No transfusion was required in the batch group, but 4 patients in the individual group needed transfusion. Mean hospital stay was 10.7 ± 1.1 and 9.4 ± 0.8 days in the individual and the batch groups (P = 0.460). There were no significant complications or mortality in both groups.
  
  
  CONCLUSIONS
  LLLS using endoscopic staples (batch group) was found to be an easier and safer technique without morbidity or mortality.
authors.affiliation: Department of Surgery, Yeungnam University Medical Center, Daegu, Korea.
authors.forename: Beom Hui
authors.initials: BH
authors.lastname: Lee
authors.affiliation: Department of Surgery, Yeungnam University Medical Center, Daegu, Korea.
authors.forename: Sung-Su
authors.initials: SS
authors.lastname: Yun
authors.affiliation: Department of Surgery, Yeungnam University Medical Center, Daegu, Korea.
authors.forename: Man Ki
authors.initials: MK
authors.lastname: Kim
authors.affiliation: Department of Surgery, Yeungnam University Medical Center, Daegu, Korea.
authors.forename: Hwa-Kyung
authors.initials: HK
authors.lastname: Jung
authors.affiliation: Department of Surgery, Yeungnam University Medical Center, Daegu, Korea.
authors.forename: Dong-Shik
authors.initials: DS
authors.lastname: Lee
authors.affiliation: Department of Surgery, Yeungnam University Medical Center, Daegu, Korea.
authors.forename: Hong-Jin
authors.initials: HJ
authors.lastname: Kim
keywords: Hepatectomy; Laparoscopy; Surgical staples