Laparoscopic liver resection for posterosuperior tumors using caudal approach and postural changes: A new technical approach

摘要: Laparoscopic liver resection (LLR) for tumors in the posterosuperior [segment (S) 7 and deep S6] is a challenging clinical procedure. This area located bottom of small subphrenic space (rib cage), with large heavy right on it when patient supine position. Thus, LLR this technically demanding because handling which necessary to obtain fine surgical view, secure hemostasis conduct so as achieve an appropriate margin cage. Handling may be performed by hand-assisted approach, robotic or using spacers, such sterile glove pouch. In addition, operative field cage, S6 obstructing laparoscopic caudal view lesions. The use intercostal ports facilitates direct lateral approach into cage target area, combination mobilization liver. Postural changes during procedure have also been reported facilitate left positioning posterior sectionectomy semi-prone segments. our hospital, procedures are via postural changes. position used S7 segmentectomy partial resections without combined insertion. Although movement instruments restricted compared port placement para-vertebra makes manipulation feasible stable, minimum damage environment around