Comparison of standard multiport vs. reduced port left lateral liver resection

Abstract

Background: Reduced port laparoscopic liver surgery, applying a single incision (SILS) port, evolves as a new approach for minimal invasive resections of benign and malignant liver tumors. So far, it remains unclear if the technqiue is safe and which patients can benefit from this approach. Methods: We retrospectively analyzed the postoperative course of all consecutive patients undergoing minimally invasive left lateral sectionectomy at our center between 2009 and 2016. Results: In total, 39 minimal-invasive left lateral sectionectomies were performed between July 2009 and September 2016. 31 were performed in standard multiport and 8 in SILS reduced port technique. 5 patients of the multiport group and 3 of the reduced port group were excluded from the analysis due to multivisceral resections. Length of operation was significantly shorter in the reduced port group (206 min. vs. 149 min., p=0.031). The morbidity rate was 19.2% in the multiport group and 0% in the reduced port group, respectively. No mortality was observed in both groups. Length of hospital stay did not significantly differ in both groups (median 7 vs. 5 days, p=0.367). Conclusion: Single incision left lateral sectionectomy is a safe and effective procedure for both benign and malign hepatic lesions. Compared to multiport resections it is faster due to the possibility of specimen retrieval through the umbilical incision. In case of intraoperative bleeding the SILS port can easily be converted to a hand-port, allowing for manual compression of the liver.