Pure laparoscopic liver resection for giant liver hemangioma with extrahepatic growth based on preoperative 3-dimensional simulation: A case report

Yuichiro Okumura,Kunihito Gotoh,Yoshifumi Iwagami,Hirofumi Akita,Takehiro Noda,Shogo Kobayashi,Hidetoshi Eguchi,Takehiko Hanaki,Koji Umeshita,Masaki Mori,Yuichiro Doki,Tadafumi Asaoka

doi:10.1186/s40792-019-0607-8

Yuichiro Okumura, Kunihito Gotoh + Show 10 more

Open Access

https://doi.org/10.1186/s40792-019-0607-8

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Abstract

BackgroundPerforming laparoscopic liver resection for giant hemangiomas is challenging, and careful preoperative planning is essential. Controlling intraoperative bleeding and handling surgical instruments within a limited workspace is necessary.Case presentationIn the present case, the patient was a 38-year-old woman diagnosed with a 16-cm giant liver hemangioma in segment 5/6, with extrahepatic growth. Preoperative three-dimensional simulations for port placement and the laparoscopic view from the left upper abdomen were performed to complete the pure laparoscopic liver resection. The laparoscopic resection was then safely performed on the same way.ConclusionsPure laparoscopic resection could be applied to giant hemangiomas with extrahepatic growth, and the preoperative three-dimensional simulation of port placement and the laparoscopic view might be helpful when the intraabdominal workplace is restricted.

Highlights

Cavernous hemangiomas are the most common type of benign liver tumors, and the majority of cavernous hemangiomas are incidentally detected by imaging studies performed for other reasons [1]
Pure laparoscopic resection could be applied to giant hemangiomas with extrahepatic growth, and the preoperative three-dimensional simulation of port placement and the laparoscopic view might be helpful when the intraabdominal workplace is restricted
* Correspondence: heguchi@gesurg.med.osaka-u.ac.jp 1Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, 2-2, Yamadaoka E-2, Suita, Osaka 565-0871, Japan Full list of author information is available at the end of the article diameter that was successfully resected by laparoscopic liver resection (LLR) after utilizing three-dimensional (3D) simulation technology to preoperatively plan port placement and the laparoscopic view

Summary

Introduction

Cavernous hemangiomas are the most common type of benign liver tumors, and the majority of cavernous hemangiomas are incidentally detected by imaging studies performed for other reasons [1]. Conclusions: Pure laparoscopic resection could be applied to giant hemangiomas with extrahepatic growth, and the preoperative three-dimensional simulation of port placement and the laparoscopic view might be helpful when the intraabdominal workplace is restricted. A recent national survey reported that liver hemangiomas measuring > 10 cm would be candidates for surgery in patients with symptoms [2].

Results

Conclusion