Hand-assisted laparoscopic liver surgery

Archives of Surgery
Mark C AntonettiRocco Orlando

Abstract

The hand-assisted laparoscopic technique may be applied to the treatment of liver tumors. A case series with mean follow-up of 13 months. University-affiliated tertiary care center. A total of 15 patients with hepatic neoplasms underwent screening tests, including appropriate tumor marker analyses, abdominal sonography, and computed tomographic scan and, in most cases, magnetic resonance imaging to determine operability. Contraindications included extrahepatic disease, more than 5 liver lesions, coagulopathy, and ascites. Between March 1, 1998, and April 30, 2001, 15 patients underwent 16 hand-assisted diagnostic laparoscopic operations to rule out extrahepatic disease. Four patients had extrahepatic disease. In the 11 patients without evidence of extrahepatic disease, intraoperative ultrasound was used to establish the number and location of liver lesions. Operative strategies included resection, cryoablation, or both. Operative time, conversion to open procedure, length of stay, complications, and recurrence of disease. Of the 15 patients with liver tumors, 6 patients had more extensive disease than was detected by either preoperative imaging or laparoscopic exploration They included extrahepatic disease (3), additional liver...Continue Reading

Citations

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