Department of Surgery, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul, 110-744, South Korea.
Department of Surgery, Division of HBP Surgery and Liver Transplantation, Korea University Anam Hospital, Korea University Medical College, Seoul, South Korea.
Surg Endosc. 2019 May;33(5):1667-1673. doi: 10.1007/s00464-018-6594-1. Epub 2018 Nov 21.
Interest in pure laparoscopic donor hepatectomy (PLDH) is increasing worldwide with the donor's cosmetic demands and improvements in surgical techniques. Efficient manipulation of flexible scope is mandatory for successful PLDH, especially in right hepatectomy which requires more mobilization. This study provides guidelines on how to manipulate optimally a flexible scope.
Data from 158 donors who underwent pure laparoscopic donor right hepatectomy (PLDRH) between November 2015 and December 2017 were retrospectively reviewed.
None of the donors required transfusion, conversion to open hepatectomy, or experienced any irreversible disabilities or mortalities. Three types of laparoscopic view provided by the flexible scope, which are bird's eye view, low angle view, and lateral view, were applied to each step of the procedure.
PLDRH can be successfully performed with maximizing visibility given by the tips and pitfalls in manipulating the flexible scope.
随着供体美容需求的增加和手术技术的进步，全球范围内对纯腹腔镜供肝切除术（PLDH）的兴趣日益浓厚。成功实施 PLDH 需要灵活的镜体进行高效操作，尤其是在需要更多游离的右半肝切除中。本研究提供了关于如何优化灵活镜体操作的指南。
回顾性分析了 2015 年 11 月至 2017 年 12 月期间 158 例接受纯腹腔镜供肝右半切除术（PLDRH）的供者的数据。
无供者需要输血、转为开腹肝切除术，或发生任何不可逆转的残疾或死亡。在手术的每一步中，均应用了由柔性镜体提供的三种腹腔镜视图，即鸟瞰视图、低角度视图和侧视图。
通过灵活镜体的技巧和窍门，可以最大限度地提高可视性，从而成功实施 PLDRH。
