Application of the cold cutting technique in transumbilical single-incision laparoscopic liver resection

Abstract

Objective To study the application of the cold cutting technique in transumbilical single-incision laparoscopic liver resection (TUSI-LLR), and to evaluate its feasibility and treatment results. Methods The clinical data of 35 patients with liver lesions treated by transumbilical single-incision laparoscopic liver resection from 2013 to 2017 were retrospectively analyzed in Shengjing Hospital of China Medical University. In all these patients, the liver parenchyma was transected with the cold cutting technique. The operation time, intraoperative blood loss, postoperative complications, time to remove abdominal drain, and total hospital stay in the patients were analyzed. Results 11 of the 35 patients were male. The average age was (49.9±10.8) years. The average body weight was (63.2±11.1) kg. The diagnoses were hemangiomas in 18 patients, hepatolithiasis in 5 patients, malignant hepatocellular tumors in 5 patients, focal nodular hyperplasia in 3 patients, and others in 4 patients. There were 22 left lateral sectionectomies, 2 left hemihepatectomies, 11 wedge resections (8 in the left and 3 in the right). The operations were all successfully performed, with no conversion to conventional laparoscopic hepatectomy or open surgery. The average operation time was (112.2±51.0) minutes, and the intraoperative blood loss was (105.4±70.1) ml. No patients required intraoperative blood transfusion. The average surgery cost was (36 336.7±5 938.2) yuan. All patients recovered well, with no postoperative hemorrhage, bile leakage, or incisional wound infection. The average time periods for removal of the abdominal drain, and hospital stay were (4.5±1.2) days and (5.2±1.4) days, respectively. All the 35 patients were followed up (1~3 months), with no patients complaining of abdominal distension or abdominal pain. Conclusions The cold cutting technique in transumbi-lical single-incision laparoscopic liver resection was safe and feasible. Its benefits included the operative speed, the small amount of intraoperative blood loss and the rapid postoperative recovery of the patients. Key words: Cold cutting technique; Liver resection, laparoscopic, single incision; Stapling devices