Laparoscopic wedge resection of parenchymal organs: our experience.

Introduction: Laparoscopic wedge resection (LWR) of parenchymal organs (PO) can be performed safely in many instances. Bleeding and or postoperative bile leaks are the most common complications following these operations. Methods: Between June 2006 and June 2007, 19 LWR of liver and of kidney were performed (11 males and 8 females). Mean age 55.7 yrs (range 31–68). They were 13 hepatic metastases and 6 renal cell carcinomas. Ultracision® and Ligasure® devices were used respectively in 15 and 4 cases. Hemostasis was always completed by using a combination of fibrin glue, gelatine matrix thrombin or fibrin sponge. Results: All procedure were completed laparoscopically, mean operative time 115 minutes (range 75–190), mean blood loss 250 ml (50–400), mean postoperative stay 5 days (3–8). Discussion: LWR of PO using modern surgical instruments, ultrasonic or radiofrequency devices, with biologic hemostatic and sealant agent, is technically simple and safety and permits to decrease intra and postoperative complications. Indications are limited to resection of subglissonian lesions of II-III-IV-V-VI hepatic segments and of cortical renal nodules without involvement of pelvis.