Technical considerations in laparoscopic liver surgery - A solid organ easily forgotten?

Background: Laparoscopic solid organ surgery has gained growing acceptance, but this does not hold for laparoscopic surgery of the liver. Laparoscopic liver surgery mainly comprizes diagnostic procedures and treatment of live r cysts. However, we believe there is room for a laparoscopic approach to t he liver in selected cases, with the benefits that may be expected from lap aroscopic solid organ surgery. Methods: Between 1993 and 2000, 10 patients with various lesions of the liv er underwent laparoscopic surgery. Indications consisted of cystic disease (n = 2), hemangioma (n = 2), focal nodular hyperplasia (n = 2), liver abces s (n = 1), and liver metastasis (n = 3). Laparoscopic treatment varied from fenestration (n = 3) to wedge resections (n = 5), and formal left lateral hepatectomy (n = 2). Results: The mean patient age was 54 years (range, 34-71 years). The mean o perative time, including laparoscopic ultrasonography, measured 180 min (ra nge, 80-240 min). Peroperative blood loss ranged from 200 to 450 ml. There was no mortality. In two patients, conversion to laparotomy was necessary. There were no postoperative complications. The mean hospital stay was 6 day s (range, 4-11 days). Conclusion: Laparoscopic treatment should be considered in selected patient s with benign and malignant lesions in the left lobe or frontal segments of the liver.