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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

Postoperative finding of laparoscopic left lateral sectionectomy using an Endo-GIA (Ethicon Endo-Surgery Inc., Cincinnati, OH, USA) and a 60-mm white cartridge. Arrow: The staple line is always located at the lowermost portion of transected liver parenchyma.
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Figure 6: Postoperative finding of laparoscopic left lateral sectionectomy using an Endo-GIA (Ethicon Endo-Surgery Inc., Cincinnati, OH, USA) and a 60-mm white cartridge. Arrow: The staple line is always located at the lowermost portion of transected liver parenchyma.

Mentions: Finally, in both group, specimen extraction was conduction using a protective bag through a supraumbilical port site subsequently extended by a midline incision. After careful hemostasis, an Argon beam was applied to the transection surface and fibrin glue was applied to staple lines. Prophylactic abdominal drains were placed in the transection surface (Fig. 6).


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)

Postoperative finding of laparoscopic left lateral sectionectomy using an Endo-GIA (Ethicon Endo-Surgery Inc., Cincinnati, OH, USA) and a 60-mm white cartridge. Arrow: The staple line is always located at the lowermost portion of transected liver parenchyma.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 6: Postoperative finding of laparoscopic left lateral sectionectomy using an Endo-GIA (Ethicon Endo-Surgery Inc., Cincinnati, OH, USA) and a 60-mm white cartridge. Arrow: The staple line is always located at the lowermost portion of transected liver parenchyma.
Mentions: Finally, in both group, specimen extraction was conduction using a protective bag through a supraumbilical port site subsequently extended by a midline incision. After careful hemostasis, an Argon beam was applied to the transection surface and fibrin glue was applied to staple lines. Prophylactic abdominal drains were placed in the transection surface (Fig. 6).

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