Laennec’s approach for laparoscopic anatomic hepatectomy based on Laennec’s capsule
Abstract Background Although isolating Glissonean pedicles and hepatic veins are critical procedures during anatomical hepatectomy, there is no standardized approach. We propose the novel Laennec’s approach for laparoscopic anatomic hepatectomy (LAH) based on Laennec’s capsule, which serves as the a...
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| Format: | Article |
| Language: | English |
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BMC
2019-11-01
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| Series: | BMC Gastroenterology |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12876-019-1107-9 |
| _version_ | 1818204781533986816 |
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| author | Yue Hu Jiong Shi Shaohe Wang Wenjie Zhang Xitai Sun Beicheng Sun Decai Yu |
| author_facet | Yue Hu Jiong Shi Shaohe Wang Wenjie Zhang Xitai Sun Beicheng Sun Decai Yu |
| author_sort | Yue Hu |
| collection | DOAJ |
| description | Abstract Background Although isolating Glissonean pedicles and hepatic veins are critical procedures during anatomical hepatectomy, there is no standardized approach. We propose the novel Laennec’s approach for laparoscopic anatomic hepatectomy (LAH) based on Laennec’s capsule, which serves as the anatomic landmark for LAH. The aim of this study was to elucidate that the natural gap between Laennec’s capsule and the adjacent tissues contributes to standardization of the surgical technique for LAH. Methods Eighty-four cases were enrolled in this observable clinical trial. They underwent LAH for liver diseases. Laennec’s approach was proposed for LAH based on Laennec’s capsule. The liver tissues close to Glissonean pedicle, hepatic veins, naked area, and inferior vena cava were collected for hematoxylin and eosin, resorcinol-fuchsin staining, and immunohistochemistry. Results The staining revealed capsule packaging of the whole liver independent of the adjacent tissues and intrahepatic vessels. A natural gap was found between Laennec’s capsule and the adjacent tissues at different sites. Laennec’s capsule served as the landmark for isolating Glissonean pedicle and hepatic veins, mobilizing the liver, and performing Hanging maneuver. Eighty-four cases underwent LAH for liver diseases using this strategy. The operation time was 277.23 min. The mean of hospital days was 9.8. Conclusions Laennec’s approach based on Laennec’s capsule contributes to standardization of the surgical technique for LAH, and brings innovations that facilitates safe and effective liver resection under laparoscopy. |
| first_indexed | 2024-12-12T03:46:42Z |
| format | Article |
| id | doaj.art-f22b0e8c22594da5b5ba1e2be1136d90 |
| institution | Directory Open Access Journal |
| issn | 1471-230X |
| language | English |
| last_indexed | 2024-12-12T03:46:42Z |
| publishDate | 2019-11-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Gastroenterology |
| spelling | doaj.art-f22b0e8c22594da5b5ba1e2be1136d902022-12-22T00:39:32ZengBMCBMC Gastroenterology1471-230X2019-11-011911910.1186/s12876-019-1107-9Laennec’s approach for laparoscopic anatomic hepatectomy based on Laennec’s capsuleYue Hu0Jiong Shi1Shaohe Wang2Wenjie Zhang3Xitai Sun4Beicheng Sun5Decai Yu6Biobank of Nanjing Drum Tower Hospital, The Affiliated Drum Tower Hospital, School of Medicine, Nanjing UniversityDepartment of Pathology, Nanjing Drum Tower Hospital, The Affiliated Drum Tower Hospital, School of Medicine, Nanjing UniversityHepatobiliary and Pancreatic Center & Liver Transplantation Center, The Affiliated Drum Tower Hospital, School of Medicine, Nanjing UniversityHepatobiliary and Pancreatic Center & Liver Transplantation Center, The Affiliated Drum Tower Hospital, School of Medicine, Nanjing UniversityHepatobiliary and Pancreatic Center & Liver Transplantation Center, The Affiliated Drum Tower Hospital, School of Medicine, Nanjing UniversityHepatobiliary and Pancreatic Center & Liver Transplantation Center, The Affiliated Drum Tower Hospital, School of Medicine, Nanjing UniversityHepatobiliary and Pancreatic Center & Liver Transplantation Center, The Affiliated Drum Tower Hospital, School of Medicine, Nanjing UniversityAbstract Background Although isolating Glissonean pedicles and hepatic veins are critical procedures during anatomical hepatectomy, there is no standardized approach. We propose the novel Laennec’s approach for laparoscopic anatomic hepatectomy (LAH) based on Laennec’s capsule, which serves as the anatomic landmark for LAH. The aim of this study was to elucidate that the natural gap between Laennec’s capsule and the adjacent tissues contributes to standardization of the surgical technique for LAH. Methods Eighty-four cases were enrolled in this observable clinical trial. They underwent LAH for liver diseases. Laennec’s approach was proposed for LAH based on Laennec’s capsule. The liver tissues close to Glissonean pedicle, hepatic veins, naked area, and inferior vena cava were collected for hematoxylin and eosin, resorcinol-fuchsin staining, and immunohistochemistry. Results The staining revealed capsule packaging of the whole liver independent of the adjacent tissues and intrahepatic vessels. A natural gap was found between Laennec’s capsule and the adjacent tissues at different sites. Laennec’s capsule served as the landmark for isolating Glissonean pedicle and hepatic veins, mobilizing the liver, and performing Hanging maneuver. Eighty-four cases underwent LAH for liver diseases using this strategy. The operation time was 277.23 min. The mean of hospital days was 9.8. Conclusions Laennec’s approach based on Laennec’s capsule contributes to standardization of the surgical technique for LAH, and brings innovations that facilitates safe and effective liver resection under laparoscopy.http://link.springer.com/article/10.1186/s12876-019-1107-9Laparoscopic anatomic hepatectomyLaennec’s capsuleSurgical practiceNatural gap |
| spellingShingle | Yue Hu Jiong Shi Shaohe Wang Wenjie Zhang Xitai Sun Beicheng Sun Decai Yu Laennec’s approach for laparoscopic anatomic hepatectomy based on Laennec’s capsule BMC Gastroenterology Laparoscopic anatomic hepatectomy Laennec’s capsule Surgical practice Natural gap |
| title | Laennec’s approach for laparoscopic anatomic hepatectomy based on Laennec’s capsule |
| title_full | Laennec’s approach for laparoscopic anatomic hepatectomy based on Laennec’s capsule |
| title_fullStr | Laennec’s approach for laparoscopic anatomic hepatectomy based on Laennec’s capsule |
| title_full_unstemmed | Laennec’s approach for laparoscopic anatomic hepatectomy based on Laennec’s capsule |
| title_short | Laennec’s approach for laparoscopic anatomic hepatectomy based on Laennec’s capsule |
| title_sort | laennec s approach for laparoscopic anatomic hepatectomy based on laennec s capsule |
| topic | Laparoscopic anatomic hepatectomy Laennec’s capsule Surgical practice Natural gap |
| url | http://link.springer.com/article/10.1186/s12876-019-1107-9 |
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