ArticleSurgical endoscopy2017
A novel model for prediction of pure laparoscopic liver resection surgical difficulty.
Article in Surgical endoscopy, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 87 papers, 2 of them syntheses that pooled it.
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Who cites it
87 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Learning Curve in Laparoscopic Liver Resection, Educational Value of Simulation and Training Programmes: A Systematic Review.World journal of surgery · 2019Pooled it
- Critical appraisal of predictive tools to assess the difficulty of laparoscopic liver resection: a systematic review.Surgical endoscopy · 2019Pooled it
- Current difficulty scoring systems may underestimate the technical complexity of segment 6 laparoscopic hepatectomy in patients with hepatocellular carcinoma.Surgical endoscopy · 2026Article
- Advanced robotic liver surgery.Surgical endoscopy · 2026Review
- Towards standardized assessment of surgical difficulty in robotic hepatobiliary surgery: a comparative validation study.Journal of robotic surgery · 2026Article
- Efficacy and Safety of a Simple Auxiliary Liver Suspension Device in Complex Laparoscopic Hepatectomy: A Multicenter Randomized Clinical Trial.Annals of gastroenterological surgery · 2026Article
- Definition and Classification of Minimally Invasive Major Hepatectomy (MIMH): A Literature Review and Expert Survey in the Fifth World Congress of the International Laparoscopic Liver Surgery (ILLS).Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2026Article
- Potential contribution of extended reality to safety in minimally invasive hepatectomy: a comparative study of laparoscopic and robotic approaches.Journal of robotic surgery · 2026Article
- Validation and applicability of the Tampa Difficulty Score for assessing procedural complexity in robotic liver surgery.Surgical endoscopy · 2026Article
- Robotic Hepatectomy for Primary Liver Cancer.Annals of surgical oncology · 2026Review
- Validation of the Institute Mutualiste Montsouris system for the stratification of laparoscopic liver resections: an international multicenter study.Hepatobiliary surgery and nutrition · 2026Article
- Article
- Assessment of surgical difficulty in multiple laparoscopic liver resection using the aggregate value of scores based on the IWATE criteria.Surgical endoscopy · 2026Article
- International Benchmark Values for Robotic Right Hepatectomy: Multicenter Study From 22 Expert Centers.Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2025Article
- External validation of Tampa Difficulty Scoring System for robotic liver resection using Americas Minimally Invasive Liver Surgery Registry (AMILES).Surgical endoscopy · 2025Article
- Exploring the potential utility of modified difficulty scores based on the IWATE criteria for assessing the surgical difficulty of laparoscopic repeat liver resection.Surgical endoscopy · 2025Article
- The impact of body mass index on short-term surgical outcomes after robotic liver surgery: a propensity-score matched analysis at a high-volume center in Denmark.Langenbeck's archives of surgery · 2025Article
- Comparison of the surgical difficulty between segment 7 and 8 partial liver resection untilizing the laparoscopic and open approaches.Surgery today · 2025Article
- Key steps of complex robotic liver surgery: an international expert survey.Surgical endoscopy · 2025Article
- Surgical treatment of hepatocellular carcinoma: an expert consensus-based practical recommendation from the Korean Liver Cancer Association.Annals of surgical treatment and research · 2025Article
27 more citing papers are in PubMed but not listed here.
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundExtending the clinical indications for laparoscopic liver resection (LLR) should be carefully considered based on a surgeon's experience and skill. However, objective indexes to help surgeons assess the estimated difficulty of LLR are scarce. The aim of our study was to develop the first objective numerical rating scale to predict the surgical difficulty of various LLR procedures.
methodsWe performed a retrospective review of the operative outcomes of 187 patients who underwent a pure LLR. First, the value of preoperative factors for predicting surgical time was evaluated by multivariate linear regression analyses, and a scoring system was constructed. Next, the integrity of our predictive linear model was evaluated against the documented operative outcomes for patients forming our study group.
resultsFour predictive factors were identified and scored based on the weighted contribution of each factor predicting surgical time: extent of resection (scored 0, 2, or 3); location of tumor (scored 0, 1, or 2); obesity (scored 0 or 1); and platelet count (scored 0 or 1). The scores were summed to classify surgical difficulty into three levels: low (total score ≤1); medium (total score 2-3); and high (total score ≥4). Operative outcomes, including surgical time, volume of blood loss, length of hospital stay, and rate of morbidity, were significantly different between the three surgical difficulty levels.
conclusionOur novel model will be useful for surgeons to predict the difficulty of an LLR procedure relative to their own experience and skill.
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