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Chuang SH, Chuang SC. Single-incision laparoscopic surgery to treat hepatopancreatobiliary cancer: A technical review. World J Gastroenterol 2022; 28:3359-3369. [PMID: 36158268 PMCID: PMC9346466 DOI: 10.3748/wjg.v28.i27.3359] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 03/20/2022] [Accepted: 06/16/2022] [Indexed: 02/06/2023] Open
Abstract
Single-incision laparoscopic surgery (SILS), or laparoendoscopic single-site surgery, was launched to minimize incisional traumatic effects in the 1990s. Minor SILS, such as cholecystectomies, have been gaining in popularity over the past few decades. Its application in complicated hepatopancreatobiliary (HPB) surgeries, however, has made slow progress due to instrumental and technical limitations, costs, and safety concerns. While minimally invasive abdominal surgery is pushing the boundaries, advanced laparoscopic HPB surgeries have been shown to be comparable to open operations in terms of patient and oncologic safety, including hepatectomies, distal pancreatectomies (DP), and pancreaticoduodenectomies (PD). In contrast, advanced SILS for HPB malignancy has only been reported in a few small case series. Most of the procedures involved minor liver resections and DP; major hepatectomies were rarely described. Single-incision laparoscopic PD has not yet been reported. We herein review the published SILS for HPB cancer in the literature and our three-year experience focusing on the technical aspects.
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Affiliation(s)
- Shu-Hung Chuang
- Division of General and Digestive Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
| | - Shih-Chang Chuang
- Division of General and Digestive Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
- School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
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Katagiri H, Nitta H, Takahara T, Hasegawa Y, Kanno S, Umemura A, Takeda D, Makabe K, Kikuchi K, Kimura T, Yanari S, Sasaki A. Standardized single-incision plus one-port laparoscopic left lateral sectionectomy: a safe alternative to the conventional procedure. Langenbecks Arch Surg 2021; 407:1277-1284. [PMID: 34866161 PMCID: PMC9151572 DOI: 10.1007/s00423-021-02340-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 09/22/2021] [Indexed: 01/22/2023]
Abstract
Purpose Laparoscopic left lateral sectionectomy (LLLS) is a feasible and safe procedure with a relatively smooth learning curve. However, single-incision LLLS requires extensive surgical experience and advanced techniques. The aim of this study is to report the standardized single-incision plus one-port LLLS (reduced port LLLS, RPLLLS) technique and evaluate its safety, feasibility, and effectiveness for junior surgeons. Methods Between January 2008 and November 2020, the clinical records of 49 patients who underwent LLLS, divided into the conventional LLLS (n = 37) and the RPLLLS group (n = 12), were retrospectively reviewed. The patient characteristics, pathologic results, and operative outcomes were evaluated. Results A history of previous abdominal surgery in the RPLLLS group was significantly high (56.8% vs. 91.7%, p = 0.552). Notably, junior surgeons performed 62.2% of the conventional LLLSs and 58.4% of the standardized RPLLLSs. There were no significant differences between the two groups in terms of median operative time (121.0 vs. 113.5, p = 0.387), median blood loss (13.0 vs. 8.5, p = 0.518), median length of hospital stays (7.0 vs. 7.0, p = 0.408), and morbidity rate (2.7% vs. 0%, p = 0.565), respectively. Conclusion This standardized RPLLLS is a feasible and safe alternative to conventional LLLS and may become the ideal training procedure for both junior surgeons and surgeons aiming to learn more complex procedures.
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Affiliation(s)
- Hirokatsu Katagiri
- Department of Surgery, Iwate Medical University School of Medicine, 2-1-1 Idai-dori, Yahaba, Iwate, 028-3609, Japan.
| | - Hiroyuki Nitta
- Department of Surgery, Iwate Medical University School of Medicine, 2-1-1 Idai-dori, Yahaba, Iwate, 028-3609, Japan
| | - Takeshi Takahara
- Department of Surgery, Fujita-Gakuen Health University School of Medicine, Aichi, Japan
| | - Yasushi Hasegawa
- Department of Surgery, Keio University School of Medicine, Tokyo, Japan
| | - Syoji Kanno
- Department of Surgery, Iwate Medical University School of Medicine, 2-1-1 Idai-dori, Yahaba, Iwate, 028-3609, Japan
| | - Akira Umemura
- Department of Surgery, Iwate Medical University School of Medicine, 2-1-1 Idai-dori, Yahaba, Iwate, 028-3609, Japan
| | - Daiki Takeda
- Department of Surgery, Iwate Medical University School of Medicine, 2-1-1 Idai-dori, Yahaba, Iwate, 028-3609, Japan
| | - Kenji Makabe
- Department of Surgery, Iwate Medical University School of Medicine, 2-1-1 Idai-dori, Yahaba, Iwate, 028-3609, Japan
| | - Koji Kikuchi
- Department of Surgery, Iwate Medical University School of Medicine, 2-1-1 Idai-dori, Yahaba, Iwate, 028-3609, Japan
| | - Taku Kimura
- Department of Surgery, Iwate Medical University School of Medicine, 2-1-1 Idai-dori, Yahaba, Iwate, 028-3609, Japan
| | - Shingo Yanari
- Department of Surgery, Iwate Medical University School of Medicine, 2-1-1 Idai-dori, Yahaba, Iwate, 028-3609, Japan
| | - Akira Sasaki
- Department of Surgery, Iwate Medical University School of Medicine, 2-1-1 Idai-dori, Yahaba, Iwate, 028-3609, Japan
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