Modified Hanging Maneuver Using the Goldfinger Dissector in Laparoscopic Right and Left Hepatectomy
Modified Hanging Maneuver Using the Goldfinger Dissector in Laparoscopic Right and Left Hepatectomy
复制标题
DOI：
10.1159/000345996
复制
发表时间：
2012-01-01
影响因子：
2.7
通讯作者：
Montalti, Roberto
中科院分区：
文献类型：
--
作者：
Troisi, Roberto I.;Montalti, Roberto
背景资料：肝脏悬吊操作是一种有用的技术，用于在开放入路中横断肝实质，同时用一根带子在下腔静脉前表面和肝实质之间穿过提起肝实质。腹腔镜肝切除术中的悬吊操作并不常用。材料与方法：我们描述了13例右肝切除术和5例左肝切除术中使用金手指剥离器的改良悬吊操作的技术和结果。该技术允许我们解剖右肝静脉和肝中静脉之间的空间;通过腔静脉前表面和肝脏后表面之间的空间创建上下弓;从后向前方向提升肝脏的切割区域;指示实质横切线。结果：中位手术时间96 min，术中出血220 ml。未记录转换。发生了2例并发症（11%）：胆瘘和呼吸窘迫综合征，均自行消退。结论：基于使用金手指解剖器的腹腔镜左右肝切除术的改良悬吊操作是安全的，可重复的，并且可以在大肝切除术中促进肝脏解剖。版权所有（c）2012 S. Karger AG，巴塞尔
Background: The liver hanging maneuver is a useful technique to transect the liver parenchyma in an open approach while lifting it with a tape passed between the anterior surface of the inferior vena cava and the liver parenchyma. The hanging maneuver during laparoscopic liver resection is not routinely utilized. Materials and Methods: We describe the technique and results of a modified hanging maneuver using the Goldfinger dissector in 13 right and 5 left hepatectomies. This technique allowed us to dissect the space between right and middle hepatic veins; to create the infero-superior arcade through the space between the anterior surface of the vena cava and the posterior surface of the liver; to lift the cutting area of the liver from the posterior to the anterior direction; to indicate the parenchymal transection line. Results:The median resection time and blood loss were 96 min and 220 ml respectively. No conversion was recorded. Two complications (11%) occurred: a biliary fistula and a respiratory distress syndrome, spontaneously resolved. Conclusions: The modified hanging maneuver for laparoscopic right and left hepatectomy based on the use of the Goldfinger dissector is safe, reproducible, and can facilitate liver dissection during major hepatectomy. Copyright (c) 2012 S. Karger AG, Basel