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Monthly publications

#January 2007
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Laparoscopic right hepatectomy: intra-hepatic Glissonian approach
This video demonstrates a totally laparoscopic approach to right hemi-hepatectomy. The right portal pedicle is first divided with an endoscopic stapler. The liver parenchyma is then divided with a combination of ultrasonic scalpel, Cavitron Ultrasound Surgical Aspirator (CUSA), bipolar cautery and clips.

Many surgeons prefer to employ the hand-assisted approach, but in this totally laparoscopic demonstration the author uses the intrahepatic Glissonian approach without the Pringle maneuver. The procedure starts with surgical exploration and laparoscopic evaluation of the liver. The harmonic scalpel divides the hepatic round and falciform ligaments. The author visualizes the suprahepatic inferior vena cava and right hepatic vein, then explores the hepatoduodenal ligament for enlarged lymph nodes. He then mobilizes the right liver as high as possible by transecting the right triangular ligament. Paying attention to the area of the adrenal gland, he dissects the gallbladder hilum, and transects both the cystic artery and duct. He starts the hepatic hilar dissection with an incision of the liver parenchyma, continuing outside the portal pedicle bifurcation toward the right and left sheet. The procedure continues with transection of the right portal pedicle.
B Topal
Surgical intervention
11 years ago
934 views
37 likes
0 comments
05:54
Laparoscopic right hepatectomy: intra-hepatic Glissonian approach
This video demonstrates a totally laparoscopic approach to right hemi-hepatectomy. The right portal pedicle is first divided with an endoscopic stapler. The liver parenchyma is then divided with a combination of ultrasonic scalpel, Cavitron Ultrasound Surgical Aspirator (CUSA), bipolar cautery and clips.

Many surgeons prefer to employ the hand-assisted approach, but in this totally laparoscopic demonstration the author uses the intrahepatic Glissonian approach without the Pringle maneuver. The procedure starts with surgical exploration and laparoscopic evaluation of the liver. The harmonic scalpel divides the hepatic round and falciform ligaments. The author visualizes the suprahepatic inferior vena cava and right hepatic vein, then explores the hepatoduodenal ligament for enlarged lymph nodes. He then mobilizes the right liver as high as possible by transecting the right triangular ligament. Paying attention to the area of the adrenal gland, he dissects the gallbladder hilum, and transects both the cystic artery and duct. He starts the hepatic hilar dissection with an incision of the liver parenchyma, continuing outside the portal pedicle bifurcation toward the right and left sheet. The procedure continues with transection of the right portal pedicle.
Total nephrectomy in children by a lateral retroperitoneoscopic approach
This didactic video demonstrates the retroperitoneal approach to nephrectomy in children. A simple technique for creation of the retroperitoneal space and different methods of dissection, vessel division and specimen extraction are presented. These techniques are applicable for use in patients ranging from infants to adolescents.

The tip of the telescope progressively enlarges the working space created in the retroperitoneoscopic approach. This frees retroperitoneal fibrous tissues behind the kidney. The authors place two additional ports under direct vision: one to gently sweep the peritoneum anteriorly and to increase the working space for the placement of a third trocar.
JS Valla
Surgical intervention
11 years ago
191 views
32 likes
0 comments
08:53
Total nephrectomy in children by a lateral retroperitoneoscopic approach
This didactic video demonstrates the retroperitoneal approach to nephrectomy in children. A simple technique for creation of the retroperitoneal space and different methods of dissection, vessel division and specimen extraction are presented. These techniques are applicable for use in patients ranging from infants to adolescents.

The tip of the telescope progressively enlarges the working space created in the retroperitoneoscopic approach. This frees retroperitoneal fibrous tissues behind the kidney. The authors place two additional ports under direct vision: one to gently sweep the peritoneum anteriorly and to increase the working space for the placement of a third trocar.