Hirose Shuntaro, Ban Daisuke, Matsui Yoshiyuki, Mizui Takahiro, Miyata Akinori, Nara Satoshi, Esaki Minoru
Department of Hepatobiliary and Pancreatic Surgery, National Cancer Center Hospital, 5-1-1, Tsukiji, Chuo-Ku, Tokyo, 1040045, Japan.
Department of Urology, National Cancer Center Hospital, 5-1-1, Tsukiji, Chuo-Ku, Tokyo, 1040045, Japan.
Surg Today. 2025 May;55(5):723-726. doi: 10.1007/s00595-024-02950-7. Epub 2024 Nov 4.
Right liver tumors involving the right adrenal gland or which are located close to the inferior vena cava (IVC) often make it difficult to mobilize the right liver during laparoscopic surgery. As an alternative approach, retroperitoneoscopy offers a relatively easy approach to the dorsal aspect of the right side of the liver and area around the IVC. Therefore, we combined laparoscopic liver resection with retroperitoneoscopy ("retlap liver resection") to exploit the benefits of these methods. The preceding retroperitoneoscopy can be used to obtain a dorsal margin, which is difficult to achieve using laparoscopy alone. In such cases, a retroperitoneoscopic approach can be applied to the dorsal side of the adrenal gland, without mobilizing the right liver. Six patients underwent retlap liver resection between 2020 and 2022 without operative complications. Because no previous reports have described laparoscopic liver resection with retroperitoneoscopy, we introduce our approach and provide a video of the procedure.
累及右肾上腺或位于下腔静脉（IVC）附近的右肝肿瘤，在腹腔镜手术中常常难以游离右肝。作为一种替代方法，后腹腔镜检查为肝脏右侧背侧及IVC周围区域提供了相对简便的入路。因此，我们将腹腔镜肝切除术与后腹腔镜检查相结合（“后腹腔镜肝切除术”），以利用这些方法的优势。先行的后腹腔镜检查可用于获得背侧切缘，这是单独使用腹腔镜难以实现的。在这种情况下，可在不游离右肝的情况下，将后腹腔镜入路应用于肾上腺背侧。2020年至2022年期间，6例患者接受了后腹腔镜肝切除术，无手术并发症。由于此前尚无关于后腹腔镜下腹腔镜肝切除术的报道，我们介绍我们的方法并提供该手术的视频。
