Our technique of preceding diaphragm resection and partial mobilization of the hepatic right lobe using a vessel sealing device (LigaSure™) for huge hepatic tumors with diaphragm invasion

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• 作者：Kenji Wakayama ; Toshiya Kamiyama ; Hideki Yokoo ; Tatsuhiko Kakisaka…
• 关键词：Liver tumor ; Diaphragm invasion ; Resection
• 刊名：Surgery Today
• 出版年：2016
• 出版时间：October 2016
• 年：2016
• 卷：46
• 期：10
• 页码：1224-1229
• 全文大小：2,399 KB
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Surgery
  Abdominal Surgery
  Thoracic Surgery
  Vascular Surgery
  Cardiac Surgery
  Surgical Oncology
  
• 出版者：Springer Japan
• ISSN：1436-2813
• 卷排序：46

文摘

We describe and assess our technique of preceding diaphragm resection and partial mobilization of the hepatic right lobe to treat a huge hepatic tumor with diaphragm invasion. The right hepatic artery and portal vein were divided at the hepatic hilum, and the mesenteries were then dissected with a vessel sealing device (LigaSure Impact™). The invaded diaphragm was dissected roundly using a vessel sealing device and the right lobe was partially mobilized. A soft catheter was then passed along the anterior aspect of the retrohepatic inferior vena cava and the liver parenchyma was dissected via a liver hanging maneuver. We performed eight hepatectomies using this technique. The median blood loss was 532.5 ml and the mean excised liver weight was 1859 g. Our results demonstrate the safety and efficiency of the preceding diaphragm resection and partial mobilization technique using a vessel sealing device for right hepatectomy to resect a very large tumor with diaphragm invasion.