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Soyama A, Murakami S, Natsuda K, Hara T, Matsuguma K, Matsushima H, Imamura H, Tanaka T, Adachi T, Hidaka M, Eguchi S. A comparison of postoperative pain between transumbilical and suprapubic incision in laparoscopic liver resection. Asian J Endosc Surg 2022; 15:608-612. [PMID: 35429138 DOI: 10.1111/ases.13063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2021] [Revised: 03/07/2022] [Accepted: 03/25/2022] [Indexed: 11/30/2022]
Abstract
BACKGROUND In laparoscopic liver resection, few reports have investigated the influence of type of incision on postoperative pain in laparoscopic liver resection. We therefore conducted the present study to clarify the difference in postoperative pain between two types of incision. METHODS Nineteen patients who underwent laparoscopic lateral sectionectomy were enrolled. In 11 patients with a transumbilical incision and eight with a suprapubic incision, the operation duration, blood loss, length of incision, duration of intravenous fentanyl infusion immediately after surgery and rescue dosage, and period of regular oral nonsteroidal anti-inflammatory drugs were evaluated. RESULTS There was no significant difference between the two groups in patients' background characteristics, operation time, or amount of blood loss. The length of suprapubic incision was significantly longer than the umbilical incision. Concerning the postoperative pain management, the duration of intravenous fentanyl administration was 1 day (1-2 days) for umbilical incisions and 1.5 days (1-2 days) for suprapubic incisions, showing no significant difference. Regarding the rescue dosage of fentanyl, the results were comparable between the groups. Regarding the postoperative duration of regular nonsteroidal anti-inflammatory drug administration, there was also no significant difference between the groups (transumbilical: 14 [5-35] days vs suprapubic: 8 [7-32]). CONCLUSIONS Postoperative pain is comparable between umbilical and suprapubic incision in patients who underwent laparoscopic left lateral segmentectomy. In terms of postoperative pain, either a transumbilical incision or a suprapubic incision can be selected for specimen extraction.
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Affiliation(s)
- Akihiko Soyama
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Shunsuke Murakami
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Koji Natsuda
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Takanobu Hara
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Kunihito Matsuguma
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Hajime Matsushima
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Hajime Imamura
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Takayuki Tanaka
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Tomohiko Adachi
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Masakaki Hidaka
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Susumu Eguchi
- Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
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Golriz M, Flossmann V, Ramouz A, Majlesara A, Kulu Y, Stojkovic M, Mehrabi A. Case Report: Successful DaVinci-Assisted Major Liver Resection for Alveolar Echinococcosis. Front Surg 2021; 8:639304. [PMID: 33748182 PMCID: PMC7969883 DOI: 10.3389/fsurg.2021.639304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2020] [Accepted: 02/03/2021] [Indexed: 12/02/2022] Open
Abstract
We report a case of successful robot-assisted major liver resection in a patient with liver alveolar echinococcosis (AE). A 62-year-old male patient was incidentally diagnosed with a large infiltrative lesion in the right liver lobe suspicious for AE. A radical surgical resection as a right-sided hemihepatectomy was indicated. The operation was carried out via a robotic-assisted procedure using the DaVinci Xi Surgical System. The tumor measured 12.4 × 8.8 cm and was successfully resected through a suprapubic incision of 13 cm. The patient was free of pain after the second post-operative day. A fluid collection near the resection plate was easily drained without bile leakage. The patient had no surgical complications. Radical resection is inevitable for adequate curative therapy of AE and provides clear margins. Robotic surgery is a relatively new and safe option for curative resection of AE lesions, with remarkable advantages for patients and surgeons.
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Affiliation(s)
- Mohammad Golriz
- Department of General, Visceral, and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany
| | - Viktoria Flossmann
- Department of General, Visceral, and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany
| | - Ali Ramouz
- Department of General, Visceral, and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany
| | - Ali Majlesara
- Department of General, Visceral, and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany
| | - Yakup Kulu
- Department of General, Visceral, and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany
| | - Marija Stojkovic
- Department of Clinical Tropical Medicine, University of Heidelberg, Heidelberg, Germany
| | - Arianeb Mehrabi
- Department of General, Visceral, and Transplantation Surgery, University of Heidelberg, Heidelberg, Germany
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Mittermair C, Weiss M, Schirnhofer J, Brunner E, Fischer K, Obrist C, de Cillia M, Kemmetinger V, Gollegger E, Hell T, Weiss H. The Shift from Multiport to Single Port Increases the Amount of Bleeding in Laparoscopic Major Hepatectomy. J Clin Med 2021; 10:jcm10030374. [PMID: 33498169 PMCID: PMC7863947 DOI: 10.3390/jcm10030374] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 01/02/2021] [Accepted: 01/18/2021] [Indexed: 12/11/2022] Open
Abstract
Background: Bleeding is a negative outcome predictor in liver surgery. Reduction in the abdominal wall trauma in major hepatectomy is challenging but might offer possible benefits for the patient. This study was conducted to assess hemostasis techniques in single-port major hepatectomies (SP-MajH) as compared to multiport major hepatectomies (MP-MajH). Methods: The non-randomized study comprised 34 SP-MajH in selected patients; 14 MP-MajH served as the control group. Intraoperative blood loss and number of blood units transfused served as the primary endpoints. Secondary endpoints were complications and oncologic five-year outcome. Results: All resections were completed without converting to open surgery. Time for hepatectomy did not differ between SP-MajH and MP-MajH. Blood loss and number of patients with blood loss > 25 mL were significantly larger in MP-MajH (p = 0.001). In contrast, bleeding control was more difficult in SP-MajH, resulting in more transfusions (p = 0.008). One intestinal laceration (SP-MajH) accounted for the only intraoperative complication; 90-day mortality was zero. Postoperative complications were noted in total in 20.6% and 21.4% of patients for SP-MajH and MP-MajH, respectively. No incisional hernia occurred. During a median oncologic follow-up at 61 and 56 months (SP-MajH and MP-MajH), no local tumor recurrence was observed. Conclusions: SP-MajH requires sophisticated techniques to ensure operative safety. Substantial blood loss requiring transfusion is more likely to occur in SP-MajH than in MP-MajH.
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Affiliation(s)
- Christof Mittermair
- Surgical Department, St John of God Hospital, Teaching Hospital of the Paracelsus Medical University Salzburg, Kajetanerplatz 1, 5010 Salzburg, Austria; (C.M.); (M.W.); (J.S.); (E.B.); (K.F.); (C.O.); (M.d.C.); (V.K.); (E.G.)
| | - Michael Weiss
- Surgical Department, St John of God Hospital, Teaching Hospital of the Paracelsus Medical University Salzburg, Kajetanerplatz 1, 5010 Salzburg, Austria; (C.M.); (M.W.); (J.S.); (E.B.); (K.F.); (C.O.); (M.d.C.); (V.K.); (E.G.)
| | - Jan Schirnhofer
- Surgical Department, St John of God Hospital, Teaching Hospital of the Paracelsus Medical University Salzburg, Kajetanerplatz 1, 5010 Salzburg, Austria; (C.M.); (M.W.); (J.S.); (E.B.); (K.F.); (C.O.); (M.d.C.); (V.K.); (E.G.)
| | - Eberhard Brunner
- Surgical Department, St John of God Hospital, Teaching Hospital of the Paracelsus Medical University Salzburg, Kajetanerplatz 1, 5010 Salzburg, Austria; (C.M.); (M.W.); (J.S.); (E.B.); (K.F.); (C.O.); (M.d.C.); (V.K.); (E.G.)
| | - Katharina Fischer
- Surgical Department, St John of God Hospital, Teaching Hospital of the Paracelsus Medical University Salzburg, Kajetanerplatz 1, 5010 Salzburg, Austria; (C.M.); (M.W.); (J.S.); (E.B.); (K.F.); (C.O.); (M.d.C.); (V.K.); (E.G.)
| | - Christian Obrist
- Surgical Department, St John of God Hospital, Teaching Hospital of the Paracelsus Medical University Salzburg, Kajetanerplatz 1, 5010 Salzburg, Austria; (C.M.); (M.W.); (J.S.); (E.B.); (K.F.); (C.O.); (M.d.C.); (V.K.); (E.G.)
| | - Michael de Cillia
- Surgical Department, St John of God Hospital, Teaching Hospital of the Paracelsus Medical University Salzburg, Kajetanerplatz 1, 5010 Salzburg, Austria; (C.M.); (M.W.); (J.S.); (E.B.); (K.F.); (C.O.); (M.d.C.); (V.K.); (E.G.)
| | - Vanessa Kemmetinger
- Surgical Department, St John of God Hospital, Teaching Hospital of the Paracelsus Medical University Salzburg, Kajetanerplatz 1, 5010 Salzburg, Austria; (C.M.); (M.W.); (J.S.); (E.B.); (K.F.); (C.O.); (M.d.C.); (V.K.); (E.G.)
| | - Emanuel Gollegger
- Surgical Department, St John of God Hospital, Teaching Hospital of the Paracelsus Medical University Salzburg, Kajetanerplatz 1, 5010 Salzburg, Austria; (C.M.); (M.W.); (J.S.); (E.B.); (K.F.); (C.O.); (M.d.C.); (V.K.); (E.G.)
| | - Tobias Hell
- Department of Mathematics, University of Innsbruck, Technikerstrasse 13, 6020 Innsbruck, Austria;
| | - Helmut Weiss
- Surgical Department, St John of God Hospital, Teaching Hospital of the Paracelsus Medical University Salzburg, Kajetanerplatz 1, 5010 Salzburg, Austria; (C.M.); (M.W.); (J.S.); (E.B.); (K.F.); (C.O.); (M.d.C.); (V.K.); (E.G.)
- Correspondence: ; Tel.: +43-(0)662-8088-8422; Fax: +43-(0)662-8088-77222
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Simultaneous laparoscopic splenectomy and right hemihepatectomy for littoral cell angiosarcoma accompanied with liver metastases. World J Surg Oncol 2013; 11:215. [PMID: 23984838 PMCID: PMC3765743 DOI: 10.1186/1477-7819-11-215] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2012] [Accepted: 08/07/2013] [Indexed: 01/01/2023] Open
Abstract
Despite the wide acceptance of laparoscopic resection for treatment of abdominal tumors, only few cases of simultaneous laparoscopic removal of the spleen and the right liver have been reported to date. Littoral cell angiosarcoma (LCAS), which arises from the littoral cells lining the sinus channels of the splenic red pulp, is a rare condition, and there is limited literature on littoral cell angiosarcoma with liver metastases. We present the case of a 28-year-old woman with postoperative pathologically-proven LCAS with right liver metastases. The patient’s surgery was safely performed, and her postoperative course was uneventful until now. This case suggests that concomitant laparoscopic splenectomy (LS) and right hemihepatectomy is a suitable surgical option for selected patients.
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