The Taping Game for the Complex G8 Glissonean Approach Is the Most Effective Technique for Laparoscopic Anatomic S8 Resection of Dandelion-Patterned Hepatic Pedicles.

Ann Surg Oncol · 2024

case_report · Level V

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Abstract

BACKGROUND: Laparoscopic anatomic segment 8 resection (LAR-S8) remains a technical challenge due to the special location of S8 and the complex classification of the Glissonean pedicle of S8 (G8). Particularly for situations in which multiple grade 4 hepatic pedicles branch out from the same point at 360° in a dandelion pattern from the right anterior hepatic pedicle, effective methods for accurately locating the target G8 and the intersegmental plane between S8 and the adjacent hepatic segment remain lacking. METHODS: This report describes a LAR-S8 guided by the indocyanine green (ICG) negative-staining method using the "taping game for complex G8 Glissonean approach" in a patient with a typical dandelion-patterned G8. RESULTS: The operative time was 150 min, with a blood loss of 50 mL and no complications. The patient was discharged 5 days postoperatively. Regular follow-up evaluation during 24 months showed no recurrence. CONCLUSIONS: The taping game is an effective method for S8 resection, especially for patients with complex G8 patterns such as the dandelion pattern.