Hand-assisted laparoscopic liver resection using Habib's technique: early experience

INTRODUCTION: Hand-assisted laparoscopic liver surgery, a newly developed technique based on an innovative concept, has proved useful and safe for a variety of less invasive hepatectomies. Radiofrequency-assisted hepatic resection has been reported to be safe, associated with minimal morbidity and mortality and decreased intraoperative blood loss and transfusion requirements. AIM: We describe how we perform hand-assisted laparoscopic radiofrequency-assisted hepatic resection using a bipolar radiofrequency device. RESULTS: The use of the hand port has allowed the surgeon to use his hand in direct liver manipulation, mobilization, and retraction. It was also useful for tactile tumour localization. Radiofrequency-assisted hepatic parenchymal transection was performed on 15 patients using a bipolar device (Habib 4X) with minimal blood loss (74 ml), and very decent operative and resection times (92 min, 33 min respectively). CONCLUSIONS: This combined procedure offers a safe, effective and rapid liver resection technique. This might encourage surgeons to perform a minimally invasive approach for liver resection more frequently.