LAPAROSCOPIC HEPATIC RESECTION - A NEW AND SAFE PROCEDURE BY ABDOMINAL-WALL LIFTING METHOD

HCC is well known for its high incidence of intrahepatic tumor recurre nce and many patients suffering from them, usually undergo further tre atments, such as PEI, TAE, MCNT or hepatic resection. However, convent ional hepatic resection by large shin, incision causes severe intraabd ominal adhesions, which disturb US examination and further treatments. The aim of the laparoscopic procedure is to prevent intraabdominal ad hesions. This is a study of the feasibility of Laparoscopic hepatic re section. without CO, pneumoperitoneum, which is not yet popular, as a safe and effective procedure. The patient in this study had a solitary HCC in the lateral segment. Mobilization of the lateral segment, diss ections of the left hepatic artery and portal venous branches, i.e. P2 and P3, were performed under CO, gas insufflation. However, to avoid CO, gas embolism, further procedures, including parenchymal compressio n and hepatic venous dissection, were performed using the abdominal wa ll lifting method without pneumoperitoneum. The patient could eat on. the second postoperative day and had art uneventful postoperative reco very and was discharged from the hospital 13 days after surgery. Hospi tal stay was shorter than conventional hepatic resections with large s hin. incisions. The importance of this procedure lies in that it is no t only a minimally invasive procedure, but also provides us with the p ossibilities of further treatments, including PEI and re-hepatic resec tion.