RETRIEVAL OF LIVER SPECIMEN IN LAPAROSCOPIC HEPATECTOMY

A series of experimental and clinical laparoscopic hepatectomies has b een performed. An experimental left lateral lobectomy of the liver of a pig was performed safely in four cases. The five clinical cases invo lved two metastatic liver tumours, one hepatocellular carcinoma, one h aemangioma and one case of Wilson's disease. The operative methods use d were left lateral segmentectomy in two cases, and partial hepatectom y of the left lobe in three cases. The four cases were performed safel y although one left lateral segmentectomy unfortunately required open laparotomy due to haemorrhage. It was necessary to insert five trocars for operative manipulation in most cases. After insertion of trocars, we changed to abdominal wall lifting without pneumoperitoneum. For pa renchymal division, ultrasonic surgical dissection was used in combina tion with a microwave tissue coagulator. The branched vessels and duct s in the liver were transected after clipping. Haemostasis of the tran section plane was secured by using an argon beam coagulator and fibrin starch. Laparoscopic hepatectomy is accordingly considered to be a fe asible operation applicable in selected patients.