The aim of this study was to analyze the data related to our laparoscopy-assisted open resections (hybrid procedure) through a short upper midline incision in various types of living donor hepatetomies.
Patients and methods
Of 175 living donors from August 1997 to January 2013, 39 underwent hybrid procedure, and enrolled in this study. The procedures included right hepatectomy in13, extended left hepatectomy in 24, left hepatectomy in 1, and right lateral sectorectomy in 1. Hybrid procedure was started with short upper median incision of 8cm, and after laparoscopic hand-assisted liver mobilization, subsequent procedures including dissection between the liver and vena cava, hepatic hilum dissection, and liver resection were performed under direct vision with extended upper median incision of 10 cm in left hepatectomy, and 12cm in right hepatectomy.
In all cases, hybrid procedure was completed without requiring extension or change of the incision. When compared to the 30 cases with ordinary right subcostal incision extended to upper median incision (ordinary group), the median duration of the surgery was not significantly different (439 minutes (range, 324-581) in hybrid group vs 391 minutes (323-550) in ordinary group) and, median blood loss was significantly less in hybrid group than in ordinary group (520g (230-1950) vs 775g (170-2920), P<0.05; Mann-Whitney test). All patients in both groups are currently doing well with normal liver function.
Our procedure of hybrid hepatectomy through a short upper midline incision is considered to be applicable for all types of living donor hepatectomies.
We believe this procedure is safe and effective because of having each benefit of ordinary open hepatectomy and laparoscopic approach, and it should be done by expert of liver surgery.
To cite this abstract in AMA style:Takatsuki M, Soyama A, Torashima Y, Kinoshita A, Adachi T, Kitasato A, Fujita F, Kanetaka K, Kuroki T, Eguchi S. Hybrid Procedure of Laparoscopic-Assisted Open Liver Resection in Living Donor Hepatectomy, A [abstract]. Am J Transplant. 2013; 13 (suppl 5). http://atcmeetingabstracts.com/abstract/hybrid-procedure-of-laparoscopic-assisted-open-liver-resection-in-living-donor-hepatectomy-a/. Accessed September 24, 2017.
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