Laparoscopic liver resections

THOUGH STILL PRACTICED IN ONLY A FEW CENTRES WORLDWIDE, LAPAROSCOPIC LIVER RESECTIONS, PARTICULARLY LEFT HEPATECTOMY OFFER ADVANTAGES OVER THE CONVENTIONAL OPEN APPROACH IN TWO IMPORTANT RESPECTS: reduced operative blood loss and lower major postoperative morbidity. Two approaches are used: the totally laparoscopic and the hand-assisted technique, which in the author's opinion facilitates both the execution and safety of these procedures, especially major resection of the right liver (right hepatectomy and pluri-segmentectomies). Technologies, which have enabled hepatic resections include: laparoscopic contact ultrasound, linear cutting staplers, ultrasonic dissection, LigaSure and TissueLink. The components operative steps necessary for these resections as practised by the author are described in this review.