Pure laparoscopic right hepatectomy with the hanging maneuver for multiple hepatocellular adenomas.

Abstract

A 54-year-old woman with multiple telangiectatic hepatocellular adenoma without degeneration (>5 cm) underwent laparoscopic right hepatectomy with the hanging maneuver. The patient was installed in the supine position with the legs spread apart. Five trocars were used for the intervention. The liver hanging maneuver was performed up-to-down with a nasogastric tube and no prior mobilization of the right liver. Surgery lasted 270 min with 100 ml of blood loss and 15 min of hepatic pedicle clamping. The patient was discharged on postoperative day 7. This anterior approach avoids difficult mobilization of the right liver, guides the anatomical transaction plane, limits bleeding, and increases the number of patients who can benefit from the laparoscopic approach.