ArticleSurgical endoscopy2019
A novel very simple laparoscopic hepatic inflow occlusion apparatus for laparoscopic liver surgery.
Article in Surgical endoscopy, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed, 7 citations in OpenAlex.
- "Hooking method" for hepatic inflow control: a new approach for laparoscopic Pringle maneuver.World journal of surgical oncology · 2023Article
- The Pringle maneuver in the modern era: A review of techniques for hepatic inflow occlusion in minimally invasive liver resection.Annals of hepato-biliary-pancreatic surgery · 2023Review
- Laparoscopic hepatectomy enhances recovery for small hepatocellular carcinoma with liver cirrhosis by postoperative inflammatory response attenuation: a propensity score matching analysis with a conventional open approach.Surgical endoscopy · 2021Article
- A novel simple intra-corporeal Pringle maneuver for laparoscopic hemihepatectomy: how we do it.Surgical endoscopy · 2020Article
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Authors and funding
7 authors at 1 institution in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundControl of bleeding is extremely important for laparoscopic liver resection. We introduce a new and operationally simple laparoscopic hepatic inflow occlusion apparatus (LHIOA) and its successful application in laparoscopic surgery for patients with cirrhosis.
methodsThe self-designed LHIOA was constructed using a tracheal catheter (7.5#) and infusion set. The tracheal catheter and infusion set were trimmed to 30 and 70 cm, to serve as an occlusion tube and occlusion tape, respectively. After establishment of pneumoperitoneum, the occlusion tape was inserted to encircle the hepatoduodenal ligament. The occlusion tube was then introduced and the ends of the occlusion tape were pulled out of it to occlude the hepatic inflow. Under intermittent vascular occlusion with the LHIOA, the liver parenchyma was transected using an ultrasonic scalpel and monopolar electrocoagulation. Outcomes of the application of the LHIOA in hepatocellular carcinoma patients with cirrhosis (LHIOA group, n = 46) were compared with patients undergoing laparoscopic hepatectomy without LHIOA (non-LHIOA group, n = 46), using one-to-one propensity case-matched analysis.
resultsThe LHIOA effectively occluded the hepatic inflow while showing no damage to the hepatoduodenal ligament. The time required for presetting the LHIOA is 6.8 ± 0.6 min. The conversion rate in the non-LHIOA group was 13.0% while there was no conversion in the occlusion group (P < 0.001). The median blood loss of patients in the LHIOA group (60 ml, range 50-200 ml) was significantly less than that of patients in the non-LHIOA group (250 ml, range 100-800) (P < 0.001). Transfusion was required in 8 patients in the non-LHIOA group while no transfusion was required in the LHIOA group. The median operative time in the LHIOA group (157 min, range 80-217 min) was significantly shorter than that in the non-LHIOA group (204 min, range 105-278 min) (P < 0.001).
conclusionsThe new LHIOA is effective, safe, and simple. It can significantly reduce conversion rate, blood loss, and operative time. It facilitates laparoscopic liver resection and is recommended for use.
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