Abstract
Background: Although trans-umbilical Single-Incision Laparoscopic Surgery (SILS) has been developing as an alternative to pure laparoscopic surgery or even natural orifice transluminal endoscopic surgery, ten reports of its use have yet been published in relation to liver resection. The aim of this article is to describe the SILS technique of liver resection for hepatocellular carcinoma in patient with compensated liver cirrhosis. Methods: Through a 4-cm vertical trans-umbilical incision, 3 trocars (1 of 12 mm and 2 of 5 mm) were inserted. The tumor was located in a peripheral lesion of segment 3 in a 34-year-old man with compensated liver cirrhosis. Liver transection was performed using radiofrequency ablation and bipolar coagulation forceps as a precoagulative device and ultrasonically activated coagulating shears under 8-mmHg of carbon dioxide pneumoperitoneum. The Pringle manoeuvre was not used. Results: The operative duration was 200 min and blood loss was 20 ml. No transfusion was required. The tumor size was 13 mm in diameter and the surgical margin was 10 mm. The postoperative course was uneventful. The patient had minimal postoperative pain and scarring and was discharged on the 6th postoperative day. Conclusion: Our result suggests that SILS liver resection could be feasible and an effective alternative to traditional pure laparoscopic liver resection that provides a more minimally invasive surgical option and the ability to hide the surgical incision within the umbilicus in selected patients.
Highlights
Laparoscopic liver resection for a benign tumor was first reported in 1991 [1]
We describe Single-Incision Laparoscopic Surgery (SILS) liver resection for hepatocellular carcinoma in a patient with compensated liver cirrhosis
Laparoscopic liver resection has been remarkably expanding over the last decade
Summary
Laparoscopic liver resection for a benign tumor was first reported in 1991 [1]. Thereafter, it has been spreading with development of devices used during the past two decades. NOTES comprise several new endoscopic and surgical entryways into the abdominal cavity with potential advantages of less invasiveness and the cosmetic. This technique is limitedly applied because it necessitates a visceral injury, leading to potential peritonitis. A Single-Incision Laparoscopic Surgery (SILS) has been developing as a minimally invasive surgery with cosmetic and painless benefits alternative to NOTES. Trans-umbilical Single-Incision Laparoscopic Surgery (SILS) has been developing as an alternative to pure laparoscopic surgery or even natural orifice transluminal endoscopic surgery, ten reports of its use have yet been published in relation to liver resection. The aim of this article is to describe the SILS technique of liver resection for hepatocellular carcinoma in patient with compensated liver cirrhosis
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