title: Laparoscopic Total Caudate Lobectomy for Hepatocellular Carcinoma.
abstract: BACKGROUND
  Caudate lobe is located in the deep dorsal area of the liver between the portal triad and the inferior vena cava (IVC). Torrential bleeding can occur from the IVC and short hepatic veins during dissection. Isolated total caudate lobe resection is still rare and technically demanding. We herein present a video on the technical aspect of laparoscopic total caudate lobectomy.
  
  
  METHODS
  A 61-year-old woman was admitted for recurrent hepatocellular carcinoma detected on imaging. She had history of multifocal hepatocellular carcinoma in July 2015 and underwent open cholecystectomy, segment 6 and segment 8 tumorectomy. Ten months later, the computed tomography scan and magnetic resonance imaging showed a 1 cm arterial enhancing lesion in segment I (S1) with no other foci of recurrence. Laparoscopic total caudate lobectomy was contemplated.
  
  
  RESULTS
  The operative time was 270 minutes. The intraoperative blood loss was 200 mL and blood transfusion was not necessary. The patient was discharged on the fourth postoperative day without any complications.
  
  
  CONCLUSIONS
  This report showed the safety and feasibility of laparoscopic total caudate lobectomy. Nonetheless, it is a technically demanding procedure. It should be performed in carefully selected patients and by experienced hepatobiliary surgeons proficient in laparoscopic liver resection.
authors.affiliation: 1 Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine , Seongnam-si, Korea.|2 Department of Surgery, Kwong Wah Hospital , Hong Kong, China .
authors.forename: Kit-Man
authors.initials: KM
authors.lastname: Ho
authors.affiliation: 1 Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine , Seongnam-si, Korea.
authors.forename: Ho-Seong
authors.initials: HS
authors.lastname: Han
authors.affiliation: 1 Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine , Seongnam-si, Korea.
authors.forename: Yoo-Seok
authors.initials: YS
authors.lastname: Yoon
authors.affiliation: 1 Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine , Seongnam-si, Korea.
authors.forename: Jai Young
authors.initials: JY
authors.lastname: Cho
authors.affiliation: 1 Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine , Seongnam-si, Korea.
authors.forename: Young Rok
authors.initials: YR
authors.lastname: Choi
authors.affiliation: 1 Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine , Seongnam-si, Korea.
authors.forename: Jae Seong
authors.initials: JS
authors.lastname: Jang
authors.affiliation: 1 Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine , Seongnam-si, Korea.
authors.forename: Seong Uk
authors.initials: SU
authors.lastname: Kwon
authors.affiliation: 1 Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine , Seongnam-si, Korea.
authors.forename: Sungho
authors.initials: S
authors.lastname: Kim
authors.affiliation: 1 Department of Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine , Seongnam-si, Korea.
authors.forename: Jang Kyu
authors.initials: JK
authors.lastname: Choi
mesh_terms: D016063:Blood Loss, Surgical; D006528:Carcinoma, Hepatocellular / Q000601:surgery*; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D008099:Liver / Q000473:pathology / Q000601:surgery; D008113:Liver Neoplasms / Q000601:surgery*; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000601:surgery; D061646:Operative Time; D014057:Tomography, X-Ray Computed
keywords: hepatocellular carcinoma; laparoscopic total caudate lobectomy; techniques