The difficulty of laparoscopic liver resection

Grading of difficulty is needed for laparoscopic liver resection (LLR). Indications for LLR are expanding worldwide from minor to major resections, particularly in institutions having surgeons with advanced skills. If the degrees of surgical difficulty were defined, it would serve as a useful guide...

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Veröffentlicht in:Updates in Surgery 2015-06, Vol.67 (2), p.123-128
Hauptverfasser: Ban, Daisuke, Kudo, Atsushi, Ito, Hiromitsu, Mitsunori, Yusuke, Matsumura, Satoshi, Aihara, Arihiro, Ochiai, Takanori, Tanaka, Shinji, Tanabe, Minoru, Itano, Osamu, Kaneko, Hironori, Wakabayashi, Go
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container_end_page 128
container_issue 2
container_start_page 123
container_title Updates in Surgery
container_volume 67
creator Ban, Daisuke
Kudo, Atsushi
Ito, Hiromitsu
Mitsunori, Yusuke
Matsumura, Satoshi
Aihara, Arihiro
Ochiai, Takanori
Tanaka, Shinji
Tanabe, Minoru
Itano, Osamu
Kaneko, Hironori
Wakabayashi, Go
description Grading of difficulty is needed for laparoscopic liver resection (LLR). Indications for LLR are expanding worldwide from minor to major resections, particularly in institutions having surgeons with advanced skills. If the degrees of surgical difficulty were defined, it would serve as a useful guide when introducing LLR and stepping up to the more advanced LLR. As no previous study has addressed the degrees of difficulty of various LLR procedures, we devised a practical scoring system for this purpose. We extracted the following five factors from preoperative information to score difficulty levels: (1) tumor location, (2) extent of liver resection, (3) tumor size, (4) proximity to major vessels, and (5) liver function. This difficulty index is comprised of the cumulative score for the five individual factors. There has not yet been a standard definition of difficulty. Our proposed scoring system might be a practical means of assessing the difficulty of LLR procedures. However, this system must be prospectively validated.
doi_str_mv 10.1007/s13304-015-0302-7
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subjects Carcinoma, Hepatocellular - pathology
Carcinoma, Hepatocellular - surgery
Female
Hepatectomy - adverse effects
Hepatectomy - methods
Humans
Laparoscopic surgery
Laparoscopy
Laparoscopy - adverse effects
Laparoscopy - methods
Liver
Liver Neoplasms - pathology
Liver Neoplasms - surgery
Male
Medicine
Medicine & Public Health
Minimally Invasive Liver Surgery: An Update
Minimally Invasive Surgical Procedures - adverse effects
Minimally Invasive Surgical Procedures - methods
Needs Assessment
Neoplasm Grading - methods
Patient Selection
Postoperative Complications - physiopathology
Postoperative Complications - therapy
Prognosis
Review Article
Risk Assessment
Surgeons
Surgery
Treatment Outcome
title The difficulty of laparoscopic liver resection
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