Heinrich Stefan, Seehofer Daniel, Corvinus Florian, Tripke Verena, Huber Tobias, Hüttl Florentine, Penzkofer Lea, Mittler Jens, Abu Hilal Mohammad, Lang Hauke
Klinik f. Allgemein‑, Viszeral- u. Transplantationschirurgie, Universitätsmedizin Mainz, Langenbeckstraße 1, 55131, Mainz, Deutschland.
Klinik u. Poliklinik für Viszeral‑, Transplantations‑, Thorax- und Gefäßchirurgie, Universitätsklinikum Leipzig, Leipzig, Deutschland.
Chirurg. 2021 Jun;92(6):542-549. doi: 10.1007/s00104-020-01288-3.
Laparoscopic liver surgery (LLS) is increasingly utilized worldwide due to several potential advantages over open liver surgery.
Analysis and presentation of the advantages and disadvantages of LLS in comparison to open surgery.
Analysis of clinically relevant factors of minimally invasive liver surgery in comparison to open liver surgery in the current literature.
In addition to obvious cosmetic advantages, the current literature shows advantages regarding length of hospital stay and quality of life after LLC. In contrast to major liver resections, parenchyma-preserving resections often appear cost-neutral due a shorter postoperative hospital stay compared to conventional liver resections. In addition to particular personnel requirements, LLS also has technical prerequisites, such as a dedicated intraoperative ultrasound system. Furthermore, contrast-enhanced laparoscopic examinations are possible and ultrasound information can be fused with preoperative imaging. Virtual reality technology and 3‑dimensional printing are currently under investigation to improve the intraoperative anatomical orientation of LLS.
The current literature reveals significant advantages for LLS so that this procedure should be further developed in Germany in order to offer this technique to as many patients as possible.
与开腹肝手术相比，腹腔镜肝手术（LLS）具有若干潜在优势，因此在全球范围内的应用日益广泛。
分析并阐述LLS与开腹手术相比的优缺点。
分析当前文献中微创肝手术与开腹肝手术的临床相关因素。
除了明显的美容优势外，当前文献显示LLS在住院时间和肝叶切除术后的生活质量方面也具有优势。与肝大部切除术不同，由于与传统肝切除术相比术后住院时间较短，保留实质的切除术在成本方面往往持平。除了特殊的人员要求外，LLS还具备技术前提条件，例如专用的术中超声系统。此外，腹腔镜造影检查可行，且超声信息可与术前影像融合。目前正在研究虚拟现实技术和三维打印技术，以改善LLS术中的解剖定位。
当前文献揭示了LLS的显著优势，因此该手术在德国应进一步发展，以便尽可能为更多患者提供此项技术。
