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Rationale and surgical technique of laparoscopic left lateral sectionectomy using endoscopic staples.

Lee BH, Yun SS, Kim MK, Jung HK, Lee DS, Kim HJ - Ann Surg Treat Res (2014)

Bottom Line: Laparoscopic left lateral sectionectomy (LLLS) has been widely accepted due to benefits of minimally invasive surgery.There was significantly shorter in the batch group, also (P = 0.006).There were no significant complications or mortality in both groups.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Yeungnam University Medical Center, Daegu, Korea.

ABSTRACT

Purpose: 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.

Conclusion: LLLS using endoscopic staples (batch group) was found to be an easier and safer technique without morbidity or mortality.

No MeSH data available.


Related in: MedlinePlus

(A) Transection of glissonian pedicles to segments II and III using an Endo-GIA (Ethicon Endo-Surgery Inc., Cincinnati, OH, USA) and a 60-mm white cartridge. (B) Transection of glissonian pedicles to segments II and III using an Endo-GIA and a 60-mm white cartridge. Arrows: staple lines after using an Endo-GIA.
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Figure 4: (A) Transection of glissonian pedicles to segments II and III using an Endo-GIA (Ethicon Endo-Surgery Inc., Cincinnati, OH, USA) and a 60-mm white cartridge. (B) Transection of glissonian pedicles to segments II and III using an Endo-GIA and a 60-mm white cartridge. Arrows: staple lines after using an Endo-GIA.

Mentions: In the individual group, glissonian pedicles were separately dissected and controlled and the LHV was controlled with Hemolock or metallic clips instead of the Endo-GIA. In the batch group, glissonian pedicles and surrounding liver tissue were controlled using an Endo-GIA (Ethicon Endo-Surgery Inc.) with a 60-mm white cartridge to the left side of the glissonian sheath (Fig. 4). In case of incomplete control of glissonian pedicles, we could perform the additional individual method or control with LHV simultaneously using endoscopic staples.


Rationale and surgical technique of laparoscopic left lateral sectionectomy using endoscopic staples.

Lee BH, Yun SS, Kim MK, Jung HK, Lee DS, Kim HJ - Ann Surg Treat Res (2014)

(A) Transection of glissonian pedicles to segments II and III using an Endo-GIA (Ethicon Endo-Surgery Inc., Cincinnati, OH, USA) and a 60-mm white cartridge. (B) Transection of glissonian pedicles to segments II and III using an Endo-GIA and a 60-mm white cartridge. Arrows: staple lines after using an Endo-GIA.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4127897&req=5

Figure 4: (A) Transection of glissonian pedicles to segments II and III using an Endo-GIA (Ethicon Endo-Surgery Inc., Cincinnati, OH, USA) and a 60-mm white cartridge. (B) Transection of glissonian pedicles to segments II and III using an Endo-GIA and a 60-mm white cartridge. Arrows: staple lines after using an Endo-GIA.
Mentions: In the individual group, glissonian pedicles were separately dissected and controlled and the LHV was controlled with Hemolock or metallic clips instead of the Endo-GIA. In the batch group, glissonian pedicles and surrounding liver tissue were controlled using an Endo-GIA (Ethicon Endo-Surgery Inc.) with a 60-mm white cartridge to the left side of the glissonian sheath (Fig. 4). In case of incomplete control of glissonian pedicles, we could perform the additional individual method or control with LHV simultaneously using endoscopic staples.

Bottom Line: Laparoscopic left lateral sectionectomy (LLLS) has been widely accepted due to benefits of minimally invasive surgery.There was significantly shorter in the batch group, also (P = 0.006).There were no significant complications or mortality in both groups.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Yeungnam University Medical Center, Daegu, Korea.

ABSTRACT

Purpose: 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.

Conclusion: LLLS using endoscopic staples (batch group) was found to be an easier and safer technique without morbidity or mortality.

No MeSH data available.


Related in: MedlinePlus