Single incision transumbilical laparoscopic left hepatic lobectomy
Epublication WebSurg.com, Jan 2012;12(01). URL: http://websurg.com/doi/vd01en3489
Background: Single-incision laparoscopy (SIL) recently gained interest mainly to improve the cosmetic outcomes. This video shows a patient submitted to left hepatic lobectomy by transumbilical SIL. Video: A 24 year-old woman with a BMI of 24.4 kg/m2 consulted for a hydatid cyst of the II-III hepatic segments. Preoperative work-up showed a hepatic hydatid cyst of the segment III, partially involving the segment II. A transumbilical SIL was performed using an 11mm trocar for a 10mm, standard length, 30-degree scope, and a curved grasping forceps, and Ligasure V. At the end of the resection, a custom-made plastic bag was inserted in the abdomen through the 11mm trocar, and the specimen was morcellated at the umbilicus inside it without tearing. Results: No conversion to open surgery or additional trocars were necessary. Total operative time was 114 minutes and laparoscopic time 96 minutes. Final umbilical incision length was 20mm. The patient’s pain medication could be kept low and the patient was discharged on the 5th postoperative day. After 6 months, the patient was well with no visible scar. Conclusion: Left hepatic lobectomy for benign lesions can safely be performed through transumbilical SIL. In the absence of malignancy, the final incision length can be kept minimal.