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Transumbilical single incision laparoscopic pericystectomy of liver segment 7

G Dapri, MD, PhD, FACS, FASMBS, Hon FPALES, Hon SPCMIN, Hon BSS, Hon CBCD, Hon CBC V Donckier, MD, PhD
Epublication WebSurg.com, Feb 2013;13(02). URL: http://websurg.com/doi/vd01en3815

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  • 2013-02-14
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Background: Transumbilical single incision laparoscopy has recently sparked interest mainly to improve cosmetic outcomes, while other potential advantages are currently under evaluation. This video presents a pericystectomy of liver segment 7 performed in a patient with a hydatic cyst. Clinical case: A 26-year-old female, without any surgical history but with a body mass index of 20.6 kg/m2 consulted for a hepatic lesion. Preoperative work-up showed a hydatic cyst of liver segment 7 with renal adhesions. The procedure was performed using an 11mm reusable port to accommodate a 10mm, 30-degree standard length scope, reusable curved instruments according to Dapri (Karl Storz Endoskope), and a straight Ligasure™ V (Covidien). Intraoperative ultrasonography allowed to identify the edges of pericystectomy. The specimen was retrieved through the umbilicus in a custom-made plastic bag, and morcellated at that level. Results: No conversion to open surgery nor insertion of additional ports were necessary. Laparoscopy took 160 minutes, and the final umbilical incision length was 16mm. Pathologic data confirmed the presence of a hydatic cyst. The patient was discharged on postoperative day 5. Conclusions: Transumbilical single incision laparoscopy is beneficial in liver surgery for benign lesions, due to minimal final scar length, which has cosmetic as well as additional potential advantages that need to be further investigated.