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HPB Surgery
Volume 2012 (2012), Article ID 921973, 9 pages
Clinical Study

Initial Experience in Single-Incision Transumbilical Laparoscopic Liver Resection: Indications, Potential Benefits, and Limitations

1Department of Gastrointestinal Surgery, European School of Laparoscopic Surgery, Saint-Pierre University Hospital, 1000 Brussels, Belgium
2Department of Anesthesiology, Saint-Pierre University Hospital, 1000 Brussels, Belgium
3Liver Unit, Department of Abdominal Surgery, Hôpital Erasme, Université Libre de Bruxelles, 808 Route de Lennik, 1070 Brussels, Belgium

Received 25 May 2012; Accepted 9 August 2012

Academic Editor: Andrea Lauterio

Copyright © 2012 Giovanni Dapri et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background. Single-incision transumbilical laparoscopic liver resection (SITLLR) has been recently described in limited series. We report our experience in SITLLR and discuss the future of this approach in terms of indications, potential benefits, and limitations, with a special reference to laparoscopic liver resection (LLR). Patients and Methods. Six patients underwent SITLLR. Indications were biliary cysts (3 cases), hydatid cysts (2), and colorectal liver metastasis (1). Procedures consisted in cysts unroofing, left lateral lobectomy, pericystectomy, and wedge resection. SITLLR was performed with 11 mm reusable trocar, 10 or 5 mm 30° scopes, 10 mm ultrasound probe, curved reusable instruments, and straight disposable bipolar shears. Results. Neither conversion to open surgery nor insertion of supplementary trocars was necessary. Median laparoscopic time was 105.5 minutes and median blood loss 275 mL. Median final umbilical scar length was 1.5 cm, and median length of stay was 4 days. No early or late complications occurred. Conclusion. SITLLR remains a challenging procedure. It is feasible in highly selected patients, requiring experience in hepatobiliary and laparoscopic surgery and skills in single-incision laparoscopy. Apart from cosmetic benefit, our experience and literature review did not show significant advantages if compared with multiport LLR, underlying that specific indications remain to be established.