Hepatectomia direita por videolaparoscopia
The first application of laparoscopic liver surgery consisted of wedge liver biopsies or resection of peripheral lesions, mostly benign. More recently, reports of anatomic left and right hepatectomy have been seen in the literature. Expertise in some centers has evolved to such an extent that even l...
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doaj-011ba2adbf934d0f84c98dfdb15e83592020-11-25T02:28:19ZengColégio Brasileiro de CirurgiõesRevista do Colégio Brasileiro de Cirurgiões1809-454634318919210.1590/S0100-69912007000300010S0100-69912007000300010Hepatectomia direita por videolaparoscopiaMarcel Autran C. Machado0Fábio F. Makdissi1Rodrigo C.T. Surjan2Antonio R. F. Teixeira3Telesforo Bacchella4Marcel C. C. Machado5Universidade de São PauloUniversidade de São PauloUniversidade de São PauloUniversidade de São PauloUniversidade de São PauloUniversidade de São PauloThe first application of laparoscopic liver surgery consisted of wedge liver biopsies or resection of peripheral lesions, mostly benign. More recently, reports of anatomic left and right hepatectomy have been seen in the literature. Expertise in some centers has evolved to such an extent that even living related donor hepatectomy has been performed. The aim of this paper is to report a laparoscopic right hepatectomy and describe in detail the surgical technique employed. To our knowledge this is the first case performed in Brazil totally laparoscopically. The surgery followed four distinct phases: complete mobilization of the liver; hilum dissection with encircling of right portal vein and right hepatic artery, caval dissection using linear vascular stapler to divide right hepatic vein and parenchymal transection with harmonic shears and firings of linear staplers are used to divide segmental 5 and 8 branches of middle hepatic vein. The liver specimen was removed by Pfannenstiel incision. Intraoperative blood loss was estimated in 120 ml with no need for blood transfusion. Hospital stay was 5 days. Laparoscopic right hepatectomy is feasible, technically demanding but can be safely accomplished by surgeons who have experience in advanced laparoscopic procedures and open hepatic surgery. In Brazil laparoscopic liver surgery is still in its first years and there is a lack of technical description of this complex procedure.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0100-69912007000300010&lng=en&tlng=enLiverLaparoscopyHepatectomy |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Marcel Autran C. Machado Fábio F. Makdissi Rodrigo C.T. Surjan Antonio R. F. Teixeira Telesforo Bacchella Marcel C. C. Machado |
spellingShingle |
Marcel Autran C. Machado Fábio F. Makdissi Rodrigo C.T. Surjan Antonio R. F. Teixeira Telesforo Bacchella Marcel C. C. Machado Hepatectomia direita por videolaparoscopia Revista do Colégio Brasileiro de Cirurgiões Liver Laparoscopy Hepatectomy |
author_facet |
Marcel Autran C. Machado Fábio F. Makdissi Rodrigo C.T. Surjan Antonio R. F. Teixeira Telesforo Bacchella Marcel C. C. Machado |
author_sort |
Marcel Autran C. Machado |
title |
Hepatectomia direita por videolaparoscopia |
title_short |
Hepatectomia direita por videolaparoscopia |
title_full |
Hepatectomia direita por videolaparoscopia |
title_fullStr |
Hepatectomia direita por videolaparoscopia |
title_full_unstemmed |
Hepatectomia direita por videolaparoscopia |
title_sort |
hepatectomia direita por videolaparoscopia |
publisher |
Colégio Brasileiro de Cirurgiões |
series |
Revista do Colégio Brasileiro de Cirurgiões |
issn |
1809-4546 |
description |
The first application of laparoscopic liver surgery consisted of wedge liver biopsies or resection of peripheral lesions, mostly benign. More recently, reports of anatomic left and right hepatectomy have been seen in the literature. Expertise in some centers has evolved to such an extent that even living related donor hepatectomy has been performed. The aim of this paper is to report a laparoscopic right hepatectomy and describe in detail the surgical technique employed. To our knowledge this is the first case performed in Brazil totally laparoscopically. The surgery followed four distinct phases: complete mobilization of the liver; hilum dissection with encircling of right portal vein and right hepatic artery, caval dissection using linear vascular stapler to divide right hepatic vein and parenchymal transection with harmonic shears and firings of linear staplers are used to divide segmental 5 and 8 branches of middle hepatic vein. The liver specimen was removed by Pfannenstiel incision. Intraoperative blood loss was estimated in 120 ml with no need for blood transfusion. Hospital stay was 5 days. Laparoscopic right hepatectomy is feasible, technically demanding but can be safely accomplished by surgeons who have experience in advanced laparoscopic procedures and open hepatic surgery. In Brazil laparoscopic liver surgery is still in its first years and there is a lack of technical description of this complex procedure. |
topic |
Liver Laparoscopy Hepatectomy |
url |
http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0100-69912007000300010&lng=en&tlng=en |
work_keys_str_mv |
AT marcelautrancmachado hepatectomiadireitaporvideolaparoscopia AT fabiofmakdissi hepatectomiadireitaporvideolaparoscopia AT rodrigoctsurjan hepatectomiadireitaporvideolaparoscopia AT antoniorfteixeira hepatectomiadireitaporvideolaparoscopia AT telesforobacchella hepatectomiadireitaporvideolaparoscopia AT marcelccmachado hepatectomiadireitaporvideolaparoscopia |
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