Translational Medicine
Open Access

Abstract

Single-Incision Laparoscopic Surgery in Liver Resection for Hepatocellular Carcinoma in Compensated Liver Cirrhosis

Akihiko Oshita, Hirotaka Tashiro, Hironobu Amano, Tsuyoshi Kobayashi and Hideki Ohdan

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.