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Application of Marionette Technique for 3-port Laparoscopic Liver Resection
Surgical Laparoscopy, Endoscopy & Percutaneous Techniques, 08/10/2012
Hsu KF et al. – The experience demonstrated that the simple marionette technique procedure could help surgeons ease laparoscopic liver resection and achieve better postoperative results.
Methods- Between June 2009 and December 2010, 7 patients underwent 3–port laparoscopic liver resection with the use of marionette technique.
- Five patients had hepatocellular carcinoma.
- Two patients with prior abdominal operations for colon cancer had colorectal liver metastasis.
- The procedure of marionette technique was performed as below: after insertion of the 3 trocars, a 2–0 nylon straight needle line was inserted through the abdominal wall, and using the needle holder, it was allowed to traverse the liver edge twice.
- Then, the straight needle line was forced out of the abdominal wall and clamped using mosquito for traction.
- Another straight needle line was similarly created at the opposite side of the liver edge.
- None of the patients had to be converted to open surgery.
- The mean operative time was 96.7±63.2 minutes (range, 45 to 195 min), and the mean volume of blood loss was 45.6±27.9 mL (range, 30 to 100 mL).
- The mean pain score recorded on the visual analog scale was 2.7±0.8.
- The mean hospital stay was 5.6±1.7 days (range, 4 to 9 d).
- Currently, all the 7 patients are alive, and the tumors have not recurred.
