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Laparoscopic liver resection using a rubber band retraction technique: usefulness and perioperative outcome in 100 consecutive cases

Authors
 Sung Hoon Choi  ;  Gi Hong Choi  ;  Dai Hoon Han  ;  Jin Sub Choi 
Citation
 SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES, Vol.29(2) : 387-397, 2015 
Journal Title
SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES
ISSN
 0930-2794 
Issue Date
2015
MeSH
Adult ; Aged ; Female ; Hepatectomy/instrumentation ; Hepatectomy/methods* ; Humans ; Laparoscopy/methods ; Learning Curve ; Liver Neoplasms/surgery* ; Male ; Middle Aged ; Operative Time ; Postoperative Complications/epidemiology ; Postoperative Period ; Retrospective Studies ; Suture Techniques ; Treatment Outcome
Keywords
Laparoscopy ; Liver resection ; Hepatectomy ; Learning curve
Abstract
BACKGROUND: Although laparoscopic liver resection is increasingly performed worldwide, surgeons still face technical challenges because of the variety of procedures used according to tumor location. In the current study, we introduce a unique retraction method using an elastic rubber band and present its learning curve in addition to the perioperative outcomes of 100 consecutive patients.
METHODS: A series of 100 consecutive patients who underwent laparoscopic liver resection using a rubber band technique between August 2008 and June 2013 were analyzed retrospectively. All the study patients underwent the rubber band technique as a method to expose the parenchymal resection plane.
RESULTS: The study subjects consisted of 56 males and 44 females with a mean age of 56.7 ± 9.6 years. There were a total of four open conversions. There was no postoperative mortality. Eighty-five patients underwent minor resection, and 15 patients underwent major resection. Among the 85 patients who underwent a minor resection, 65 patients who had favorably located tumors were compared with the 20 patients who had unfavorably located tumors. A comparison of perioperative outcomes revealed a significant difference in operative time (197.3 ± 81.9 vs. 245.9 ± 116.8 min, P = 0.040) but no differences in any other parameters. There were three (4.6 %) and one (5 %) open conversions in the favorable and unfavorable tumor location group, respectively (P = 0.954). The postoperative complication rates were not statistically different between the two groups [4 (6.2 %) vs. 1 (5 %), P = 0.848]. In the learning curve analysis, operative time and blood loss for left lateral sectionectomy (n = 14) and left hepatectomy (n = 12) and minor limited resections for posterosuperior lesions (n = 20) reached a plateau after approximately ten cases.
CONCLUSION: The retraction technique describes here using an elastic rubber band is a useful approach that results in a safe laparoscopic liver resection. Moreover, this can be applied proficiently after a reasonable learning curve.
Full Text
http://link.springer.com/article/10.1007%2Fs00464-014-3680-x
DOI
10.1007/s00464-014-3680-x
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Choi, Gi Hong(최기홍) ORCID logo https://orcid.org/0000-0002-1593-3773
Choi, Sung Hoon(최성훈)
Choi, Jin Sub(최진섭)
Han, Dai Hoon(한대훈) ORCID logo https://orcid.org/0000-0003-2787-7876
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/139803
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