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Laparoscopic surgery of liver

Youlong Wang, Wenbin Ji, Xi Zhang, Jingwang Tan
BACKGROUND: Liver resection or enucleation has been the basic treatment for liver hemangioma. However, there were few reports about laparoscopic surgery (LS) of hemangioma. The intention of this study is to explore the indication and efficacy of LS for laparoscopic hepatectomy (LH) and develop an opinion of these modern developments. PATIENTS AND METHODS: Forty-four patients with LH underwent LS, with hemihepatic vascular occlusion (HVO group n = 24) or modified vascular occlusion (MVO group n = 20), and were retrospectively reviewed, including patients' demography, surgical technique, tumor size and location, blood loss, operation time, complications, modes of hepatic vascular occlusion and changes in postoperative liver function, and the difference in patients demography and operative outcome between HVO and MVO groups were compared as well...
October 18, 2016: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
Le Xiao, Jian-Wei Li, Shu-Guo Zheng
BACKGROUND: The reported protocol was difficult to expose the hepatic veins for laparoscopic anatomical hepatectomy of segments VII and VIII. We introduce a new, convenient, applicable approach with the hepatic vein exposed from the head side. METHODS: This study included 10 patients who underwent laparoscopic liver resection for HCC in the segments VII and VIII between October, 2014 and November, 2015. Their perioperative course and operative techniques were retrospectively evaluated...
October 14, 2016: Journal of Surgical Oncology
Masakazu Hashimoto, Kei Koide, Michinori Arita, Koji Kawaguchi, Masakazu Tokunaga, Yoshihiro Mikuriya, Toshiyuki Iwamoto
BACKGROUND: Acute acalculous cholecystitis (AAC) is a relatively rare disorder of the gallbladder. Breast cancer recurrence more than 10 years after curative surgery is also infrequent. CASE PRESENTATION: Here, we report a case of a 59-year-old woman who presented with right flank pain. Her medical history included a lumpectomy for cancer of the left breast 12 years prior. Laboratory tests showed a severe inflammatory reaction and mild liver function abnormalities...
December 2016: Surgical Case Reports
Giovanni Battista Levi Sandri, Edoardo De Werra, Gianluca Mascianà, Francesco Guerra, Gabriele Spoletini, Quirino Lai
Minimally invasive surgical approaches in transplantation are gaining increasing interest, and many centers are reporting their, mainly laparoscopic, experiences. Robotic surgery (RS) has some hypothetical advantages over traditional laparoscopy, and has been successfully applied, although infrequently to organ transplantation. Our goal was to review and critique the publications reporting RS use in organ transplantation. Most of the RS experience has been with living renal donor organ procurement and, to a lesser extent, with RS procedures in the transplant recipient...
October 11, 2016: Clinical Transplantation
Georgios C Sotiropoulos, Nikolaos Machairas, Paraskevas Stamopoulos, Ioannis D Kostakis, Dimitrios Dimitroulis, Dimitrios Mantas, Gregory Kouraklis
BACKGROUND: Liver resection represents the treatment of choice for a small proportion of patients with hepatocellular carcinoma (HCC), amenable to surgery. The remarkable evolution in surgical techniques during the last decades introduced laparoscopic hepatectomy in the operative management of HCC, even in the presence of liver cirrhosis. No comparative study on laparoscopic or open liver resection for HCC has been conducted in Greece yet. METHODS: Patients undergoing liver resection for HCC by one senior hepatobiliary surgeon in our Institution during the period 11/2011-02/2016 were prospectively sampled and retrospectively analyzed for the purposes of this study...
October 2016: Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology
Melania Manco, Antonella Mosca, Francesco De Peppo, Romina Caccamo, Renato Cutrera, Ugo Giordano, Cristiano De Stefanis, Anna Alisi, Ulrich Baumann, Gianfranco Silecchia, Valerio Nobili
OBJECTIVE: To determine whether bariatric surgery is effective for the treatment of nonalcoholic steatohepatitis (NASH) in adolescence, we compared the efficacy of laparoscopic sleeve gastrectomy (LSG) with that of lifestyle intervention (nonsurgical weight loss [NSWL]) for NASH reversal in obese adolescents. STUDY DESIGN: Obese (body mass index ≥ 35 kg/m(2)) adolescents (13-17 years of age) with biopsy-proven NAFLD underwent LSG, lifestyle intervention plus intragastric weight loss devices (IGWLD), or only NSWL...
September 30, 2016: Journal of Pediatrics
Takeshi Nishikawa, Soichiro Ishihara, Tetsuo Ushiku, Keisuke Hata, Kazuhito Sasaki, Koji Murono, Koji Yasuda, Kensuke Otani, Toshiaki Tanaka, Tomomichi Kiyomatsu, Kazushige Kawai, Hiroaki Nozawa, Toshiaki Watanabe
The metastasis of rectal cancer to the anus is rare. Here, we report a case of advanced rectal cancer, which had a diffuse venous invasion with anal metastasis and multiple lymph node and liver metastases. The patient was a 72-year-old woman who complained of perianal pain and fresh blood in the stools for 6 months. She had neither history of fistula-in-ano nor anal surgery. Digital examination revealed a 2-cm tumor at the 7 o'clock position, and the barium enema and colonoscopy confirmed advanced rectal cancer...
October 1, 2016: Clinical Journal of Gastroenterology
Sung Hoon Choi, Gi Hong Choi, Dai Hoon Han, Sung Won Kwon, Jin Sub Choi
BACKGROUND: Major hurdles for laparoscopic right hepatectomy (LapRH) include difficulties in (1) mobilization and (2) applying hanging maneuver and (3) lack of experienced assistants. We discuss the protocolization of lapRH, introducing our simplified technique. METHODS: The procedure was disassembled into six steps: (1) curtailed mobilization of the right liver so as to align the resection plane with the laparoscopic camera view, (2) inflow vascular control, (3) setting up the parenchymal resection applying the rubber band retraction method, (4) parenchymal resection approaching the caudate lobe, (5) a lifting-up maneuver using a laparoscopic grasper or retractor instead of the hanging maneuver, and (6) completion of resection dividing the caudate lobe, right hepatic vein, and remaining ligament...
September 28, 2016: Annals of Surgical Oncology
Alessandro Vitale, Markus Peck-Radosavljevic, Edoardo G Giannini, Eric Vibert, Wolfgang Sieghart, Sven Van Poucke, Timothy M Pawlik
Hepatocellular carcinoma (HCC), in its very early stage, is heterogeneous both in terms of liver function (i.e. presence or absence of portal hypertension, Model for End stage Liver Disease score, Child Pugh score 5 or 6, bilirubin level) and tumour characteristics (i.e. location, alpha-fetoprotein values, pathological features such as micro-vascular invasion, tumour grade and satellitosis). Existing evidence in comparing different curative options for patients with very early HCC is poor due to small sample sizes and lack of solid subgroup analyses...
September 24, 2016: Journal of Hepatology
L X Cai, S L He, F Q Wei, Y C Yu, X J Cai
Objective: The aim was to explore the strategy and clinical value of laparoscopic transection of median hepatic fissure (MHF) in difficult laparoscopic liver resections. Methods: First the MHF was located and marked, then the transection plane of the MHF was set. Next, the laparoscopic Multifuctional Operative Dissector (LPMOD) and the technique of curettage and aspiration were utilized to transect the liver beginning from the middle portion of the gallbladder fossa, in a caudal-to-cranial and anterior-to-posterior direction, until the clear exposure of the anterior surface of the intrahepatic inferior vena cava...
September 13, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
C Salloum, C Lim, A Malek, P Compagnon, D Azoulay
Surgery using a robotic platform is expanding rapidly today, with a notable surge since its authorization on the international medical market by the US Food and Drug Administration in 2000. The first hepatectomy by a robotic approach was reported in 2002, 10 years after the first laparoscopic hepatectomy. Yet, in hepatic surgery, series are scarce and the lack of relevant data in the literature is an obstacle to the development of robot-assisted laparoscopic hepatectomy (RALH). Based on a review of the literature, this update focuses on current indications, short-term and oncologic outcomes following RALH...
September 21, 2016: Journal of Visceral Surgery
Fei Liu, Jingyi Zhang, Chuanfen Lei, Yonggang Wei, Bo Li
BACKGROUND: Though accumulated evidence proved that laparoscopic major hepatectomy was technically feasible, it remains a challenging procedure and is limited to highly specialized centers. Paragonimiasis is one of the most important food-borne parasitic zoonoses caused by the trematode of the genus Paragonimus. Although hepatic paragonimiasis is rare, the previous studies had investigated hepatic paragonimiasis from different perspectives. However, the safety and feasibility of laparoscopic major hepatectomy for hepatic paragonimiasis have not yet been reported in the literature...
September 2016: Medicine (Baltimore)
Anupam Kapur, Ranjeeta Angomchanu, Madhusudan Dey
BACKGROUND: Fibroid or myoma is the commonest reported tumor of uterus, and is one of the important reasons for hysterectomy in our setting. Different drugs are available for medical management of fibroid uterus including mifepristone, a progesterone antagonist. Varying dosage regimen for mifepristone was studied as medical management of fibroid uterus. The aim of the project was to study the effect of mifepristone on the symptoms and size of fibroids, especially using a low-dose regimen for 6 months...
October 2016: Journal of Obstetrics and Gynaecology of India
Kodai Takahashi, Hideto Ito, Toshio Katsube, Ayaka Tsuboi, Masatoshi Hashimoto, Emi Ota, Kazuhito Mita, Hideki Asakawa, Takashi Hayashi, Keiichi Fujino
Chilaiditi syndrome is defined as the interposition of the bowel between the liver and right diaphragm. It is a rare disease and may be difficult to diagnose and manage. Treatment for asymptomatic patients with Chilaiditi is usually conservative and does not require surgical intervention, but surgery may be necessary if conservative treatment fails. This report describes a rare case of Chilaiditi syndrome causing small bowel obstruction and corrected using laparoscopic surgery.
September 21, 2016: Asian Journal of Endoscopic Surgery
Stuart Lockhart, Gurpreet Singh-Ranger
Laparoscopic cholecystectomy is one of the most common procedures performed worldwide. Despite advances in technique, injury to the common bile duct and blood vessels still occurs. Rouviere's sulcus, a naturally occurring cleft in the right lobe, anterior to Segment 1, occurs in over 80% of normal livers. It is a useful, but often ignored, anatomical landmark for beginning dissection of Calot's triangle, and also for confirming its location. Despite this, its usefulness is not widely known or appreciated by general surgeons...
September 16, 2016: Asian Journal of Surgery
Arif Ahmad, Jason Jorge Arellano, Ashish Agarwala, Zoe Ahmad, Zoha Ahmad
BACKGROUND: Laparoscopic bariatric surgery requires retraction of the left lobe of the liver to provide adequate exposure of the hiatus and the stomach. Currently used approaches utilize retractors that require additional incisions and prolong operative time. OBJECTIVES: A retrospective evaluation of the efficacy and safety of a percutaneous liver retractor in a large series of patients undergoing laparoscopic bariatric surgery. SETTING: Private practice, United States...
August 18, 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
Hideo Takahashi, Nisar Zaidi, Eren Berber
BACKGROUND: There has been a recent interest in the use of Indocyanine green (ICG) imaging. The aim of this study is to review our initial experience in liver surgery. METHODS: ICG fluorescent imaging was used in 15 patients undergoing surgical treatment of their liver tumors between 2015 and 2016. ICG imaging was initially performed, followed by intraoperative ultrasound (IOUS). Findings on fluorescence were compared with preoperative cross-sectional imaging and IOUS...
September 9, 2016: Journal of Surgical Oncology
Dian-Bo Yao, Shuo-Dong Wu
The liver is a vascular-rich solid organ. Safe and effective dissection of the vessels and liver parenchyma, and control of intraoperative bleeding are the main concerns when performing liver resection. Several studies have confirmed that intraoperative blood loss and postoperative transfusion are predictors of postoperative morbidity and mortality in liver surgery. Various methods and instruments have been developed during hepatectomy. Stapling devices are crucial for safe and rapid anastomosis. They are used to divide hepatic veins and portal branches, and to transect liver parenchyma in open liver resection...
August 21, 2016: World Journal of Gastroenterology: WJG
Liu-Xin Cai, Fang-Qiang Wei, Yi-Chen Yu, Xiu-Jun Cai
OBJECTIVE: The liver hanging maneuver (LHM) is rarely applied in laparoscopic right hepatectomy (LRH) because of the difficulty encountered in retrohepatic tunnel (RT) dissection and tape positioning. Thus far no report has detailed how to quickly and easily establish RT for laparoscopic LHM in LRH, nor has employment of the Goldfinger dissector to create a total RT been reported. This study's aim was to evaluate the safety and feasibility of establishing RT for laparoscopic LHM using the Goldfinger dissector in LRH...
September 2016: Journal of Zhejiang University. Science. B
Anne-Sophie Schneck, Rodolphe Anty, Stéphanie Patouraux, Stéphanie Bonnafous, Déborah Rousseau, Cynthia Lebeaupin, Beatrice Bailly-Maitre, Arnaud Sans, Albert Tran, Jean Gugenheim, Antonio Iannelli, Philippe Gual
The long-term effects of bariatric surgery on non-alcoholic steatohepatitis (NASH), focusing on liver injury and hepatocyte apoptosis, are not well-established. We here performed a longitudinal study with paired liver biopsies of nine morbidly obese women (median BMI: 42 [38.7; 45.1] kg/m(2)) with NASH with a median follow-up of 55 [44; 75] months after laparoscopic Roux-en-Y gastric bypass (LRYGB) surgery. LRYGB surgery was associated with significant weight loss (median BMI loss -13.7 [-16.4; -9.5] kg/m(2)), improved hepatic steatosis in all patients (55...
2016: Frontiers in Physiology
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