Department of Hepato-pancreato-biliary Surgery, Moscow Clinical Scientific Center, Moscow, Russia (Drs. Efanov, Alikhanov, Kazakov, Melekhina, Kim, and Vankovich and Prof. Cvirkun). Moscow Clinical Scientific Center, Moscow, Russia (Prof. Khatkov).

ABSTRACT

Introduction: Radical surgery is the only curative method for liver alveolar echinococcosis (AE). To date, there is no information about the efficacy of laparoscopy including robot-assisted liver resection in radical treatment of AE. This is a case report of a robot-assisted radical liver resection for AE.

Case Description: A 51-year-old man was admitted to the clinic with complaints of weakness and pain in the right abdomen. Computed tomography (CT) revealed a lesion measuring 46 52 86 mm, located in liver segments VI and VII, and robot-assisted resection of those segments was performed. The surgery lasted for 485 minutes, and intraoperative blood loss was 1000 mL. The position of the patient, sites of trocars placement, and details of the surgery are described. The patient had an uneventful postoperative course and was discharged on day 10. Albendazole, was administered for 2 years as antiparasitic chemotherapy. Dynamic monitoring for more than 13 months showed no recurrence of the disease.

Discussion: Publications on the use of laparoscopic and robotic resection of posterior liver segments are scarce, but experience has shown that the learning curve for the use of the robotic system is shortened in comparison with that for other approaches. After the case reported herein, we have performed similar procedures and have seen a marked decrease in blood loss and operative time. This case and our growing experience in performing radical robot-assisted liver resections demonstrate the feasibility of using robotic laparoscopic approaches for radical treatment of early diagnosed liver AE, particularly when the affected liver segment is difficult to reach.

Key Words: Alveolar echinococcosis, Hepatectomy, Liver resection, Radical treatment, Robotic surgical procedures

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The post Radical Robot-Assisted Liver Resection for Alveolar Echinococcosis first appeared on JSLS.

Department of Surgery, University of Texas Medical School at Houston, Houston, Texas, USA (Drs. Ikoma and Shah); Keio University, School of Medicine, Tokyo, Japan (Drs. Ikoma, Itano, Oshima, and Kitagawa); Department of Surgery, Eiju General Hospital, Tokyo, Japan (Drs. Ikoma, Itano, and Oshima); Department of Surgery, Beth Israel Medical Center, New York, New York, USA (Dr. Fukuhara); Michael E. DeBakey Institute for Comparative Cardiovascular Science and Biomedical Devices, Texas A&M University, College Station, Texas, USA (Dr. Shah).

ABSTRACT

Hepatic malignancies are frequently associated with primary liver disease, including hepatitis and cirrhosis. It is not uncommon for selected patients to require repeated operations for tumor recurrence. Subsequent operations are more challenging because of dense adhesions from prior operations combined with the inherent risk for liver dysfunction. We present the case of a 64-year-old man with a 20-year history of hepatitis B who developed recurrent hepatocellular carcinoma and underwent repeated laparoscopic hepatectomies on 4 separate occasions. We found that the laparoscopic approach in repeat hepatectomy offers significant advantages, including minimal adhesions, superior visualization, and favorable effect by generated by pneumoperitoneum. Laparoscopic hepatectomy will potentially become a standard strategy for the treatment of liver malignancies associated with background liver abnormalities, which carry the high possibility of reemergence of the liver malignancy in the remnant of the liver.

Key Words: Laparoscopic surgery, Hepatectomy, HCC, Hepatitis.

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The post Laparoscopic Hepatectomy is Easier in Repeat Hepatectomy first appeared on JSLS.

Department of Surgery, Singapore General Hospital, Singapore, Singapore (Drs. Goh, Lee, Chow). Duke-NUS Graduate Medical School, Singapore, Singapore (Drs. Goh, Chow).

ABSTRACT

Introduction: Laparoscopic liver resection has increasingly been used as a therapeutic modality in hepatocellular carcinoma (HCC). However, its use in the treatment of spontaneously ruptured HCC has not been well documented.

Case Description: We describe a case of spontaneously ruptured HCC successfully treated with early totally laparoscopic liver resection.

Discussion: Early laparoscopic resection of ruptured HCC is feasible and should be considered in the treatment algorithm of selected patients who have been well stabilized.

Key Words: Laparoscopy, Hepatectomy, Hepatocellular carcinoma, Ruptured, HCC, Resection.

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The post Early Laparoscopic Resection of Ruptured Hepatocellular Carcinoma first appeared on JSLS.

Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital, Singapore (all authors). Duke–NUS Graduate Medical School, Singapore (all authors).

ABSTRACT

Laparoscopic liver resection has increasingly been used as a therapeutic modality in hepatocellular carcinoma (HCC). However, its use in the treatment of spontaneously ruptured HCC has not been well documented. We describe a case of spontaneously ruptured HCC successfully treated with hand-assisted laparoscopic liver resection.

Key Words: Hand-assisted laparoscopy, Laparoscopy, Hepatectomy, Hepatocellular carcinoma, Ruptured.

The post Early Hand-Assisted Laparoscopic Resection of Ruptured Hepatocellular Carcinoma first appeared on JSLS.

Department of Surgery, Singapore General Hospital, Singapore (all authors). Duke-NUS Graduate Medical School, Singapore (Dr. Goh).

ABSTRACT

Synchronous resection of primary neuroendocrine tumors (NET) with liver metastases remains controversial, although recent studies have demonstrated its safety in select patients. Synchronous laparoscopic gastric and liver resection has been rarely reported. We report the case of a 65-year-old man who underwent successful simultaneous D2 subtotal gastrectomy with hepatectomy and cholecystectomy for metastatic gastric NET. This is the first reported case of totally laparoscopic simultaneous D2 gastrectomy with hepatectomy and cholecystectomy for metastatic gastric NET. Laparoscopic simultaneous gastrectomy and hepatectomy is feasible and safe in select patients with metastatic gastric NET.

Key Words: Laparoscopy, Hepatectomy, Gastrectomy, Simultaneous, Neuroendocrine tumor, liver, gastric, resection, carcinoid.

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The post Totally Laparoscopic D2 Subtotal Gastrectomy with Hepatectomy and Cholecystectomy for Gastric Neuroendocrine Tumor with Liver Metastases first appeared on JSLS.