Single-Port Laparoscopic Approach of the Left Liver: Initial Experience

Abstract

IntroductionNew technological advances have enabled the development of single-port laparoscopic surgery. This approach began with cholecystectomy and subsequently with other abdominal surgeries. However, few publications on laparoscopic liver surgery have described the use of complete single-port access. We present our initial experience of a single-port laparoscopic hepatectomy. Materials and methodsBetween May 2012 and December 2013, 5 single-port laparoscopic hepatectomies were performed: 1 for benign disease and 4 for colorectal liver metastases. The lesions were approached through a 3–5cm right supraumbilical incision using a single-port access device. All the lesions were located in hepatic segments II or III. Four left lateral sectorectomies and 1 left hepatectomy were performed. ResultsMedian operative time was 135min. No cases were converted to conventional laparoscopic or open surgery. The oral intake began at 18h. There were no postoperative complications and no patients required blood transfusion. The median hospital stay was 3 days. The degree of satisfaction was very good in 4 cases and good in 1. Patients resumed their normal daily activities at 8 days. DiscussionSingle-port laparoscopic hepatectomy is safe and feasible in selected cases and may reduce surgical aggression and offer better cosmetic results. Comparative studies are needed to determine the real advantages of this approach.