New Treatment Approach in Liver Metastates: Hand- Assisted Laparoscopic Radiofrequency Liver Resection
Authors:
P. Vávra 1; A. El Gendi 3; A. Papaevangelou 4; M. Vávrová 2; L. Martínek 1; P. Ihnát 1; J. Dostalík 1
Authors‘ workplace:
Chirurgická klinika FN Ostrava, Česká republika
1; Ústav vyšetřovacích metod FN Ostrava, Česká republika
2; Department of Surgery, Main Alexandria University Hospital, Alexandria, Egypt
3; Department of Radiology, Thriasio Hospital, Elefsina, Athens, Greece
4
Published in:
Rozhl. Chir., 2007, roč. 86, č. 10, s. 554-557.
Category:
Monothematic special - Original
Overview
Background:
Hand-assisted laparoscopic liver surgery, a newly developed technique based on an innovative concept, has proved useful and safe for a variety of less invasive hepatectomies. Radiofrequency assisted hepatic resection has been reported to be safe, associated with minimal morbidity and mortality and decreased intraoperative blood loss and transfusion requirements.
Method:
We describe how we perform hand assisted laparoscopic radiofrequency assisted hepatic resection using a bipolar radiofrequency device.
Results:
The use of the hand port has allowed the surgeon to use his hand in direct liver manipulation, mobilization, and retraction. It was also useful for tactile tumor localization. Radiofrequency assisted hepatic parenchymal transaction was performed using bipolar device (Habib 4X) with minimal blood loss (35 ml), and reduced operative and resection times (75 min, 17 min respectively).
Conclusion:
This combined procedure seems to offer a safer, more effective, and less time-consuming means of resection of hepatic tumours. This might encourage surgeons to perform more frequently a laparoscopic approach for liver resection.
Key words:
hand-assisted laparoscopic liver resection – HALS – radiofrequency ablation
Sources
1. Morino, M. MI., Rosso, E., Miglietta, C., Garrone, C. Laparoscopic vs open hepatic resection: a comparative study. Surg. Endosc., 2003; 17(12): 1914–1918.
2. Vibert, E. PT., Levard, H., Denet, C., Shahri, N. K., Gayet, B., et al. Laparoscopic liver resection. Br. J. Surg., 2006; 93: 67–72.
3. Buell, JF. TM., Doty, T. C., et al. An initial experience and evolution of laparoscopic hepatic resectional surgery. Surgery, 2004; 136(4): 804–811.
4. Blumgart, LH. BJ. Liver resection for benign disease and for liver and biliary tumors. In: LH B, ed. Surgery of the Liver, Biliary tract, and Pancreas. 4th ed. Philadelphia: Saunders, 2007: 1341–416.
5. Tang, C K-WLM. Laparoscopic-assisted liver resection. J. Hepatobiliary Pancreat. Surg., 2002; 9: 105–110.
6. Fong, Y., et al. Hand assissted laparoscopic liver resection: lessons from an initial experience. Arch. Surg., 2000; 135: 854–859.
7. Kooby, D., et al. Hepatic steatosis is associated with increased complications followeing major hepatic resection but does not impact survival. Gastroenterol., 2003; 124: 794.
8. Weber, JC, NG,, Jiaom L, R,, et al. New technique for liver resection using heat coagulative necrosis. Ann. Surg., 2002; 236: 560–563.
9. Ayav, A. BP., Habib, N. A., Pellicci, R., Tierris, J., Milicevic, M., Jiao, L. R. Impact of radiofrequency assisted hepatectomy for reduction of transfusion requirements. Am. J. Surg., 2007(193): 143–148.
10. Healey, A. TJ,, Habib, N. A., Jiao, L. R. Liver resection assisted with the radiofrequency technique. In: Karaliotas, CC. BC., Habib, N. A., ed. Liver and Biliary Tract Surgery. 1st ed. Athens: Springer Werin New York 2006: 367–372.
11. Huang, M. LW,, Wang. W,, Wei. P,, Chen. R, J. Hand assisted laparoscopic hepatectomy for solid tumors in the posterior portion of the right lobe initial experience. Ann. Surg., 2003; 238(5): 674–679.
12. Bismuth, H., et al. Major hepatic resection under total vascular exclusion. Ann. Surg., 1989; 210: 13–19.
13. Hansen, PD. IA., Habib, N. A. Liver resection using total vascular exclusion, scalpel division of the parenchyma and a simple compression technique for haemostasis and biliary control. J. Gastrointest. Surg., 1999; 3: 537–542.
14. Nuzzo, G. GF., Giovianni, I., et al. Hepatic resections in normothermic ischemia. Surgery, 1996; 120: 852–858.
15. Tranberg, KG. RP., Brackett, K. A., et al. Liver resection. A comparison using Nd-YAG laser, an ultrasonic surgical aspirator, or blunt dissection. Am. J. Surg., 1986; 151: 368–373.
16. Yamamoto, Y. II., Kume, M., et al. New technique for hepatic parenchymal resection using a Cavitron ultrasonic surgical aspirator and bipolar cautery equipped with a channel for water dripping. World J. Surg., 1999; 23: 1032–1037.
Labels
Surgery Orthopaedics Trauma surgeryArticle was published in
Perspectives in Surgery
2007 Issue 10
Most read in this issue
- Biliary Ileus – A Rare Complication of Cholecystolithiasis
- Surgical Treatment of Breast Cancer in the Masaryk Memorial Cancer Institute
- Endovascular Treatment of Carotid Artery Stenosis with Cerebral Protection: 5-year Experience
- The Role of Interstitial Brachytherapy in Multimodality Management of Solid Tumors