Sonbare DJ. Approaches to laparoscopic anatomic liver resection: Does one size fit all? World J Gastroenterol 2025; 31(24): 104907 [DOI: 10.3748/wjg.v31.i24.104907]
Corresponding Author of This Article
Dhiraj John Sonbare, MD, Associate Professor, Department of Hepato-Pancreato-Biliary Surgery, Christian Medical College, Ranipet Campus, Ranipet 632517, Tamil Nādu, India. djsonbare@gmail.com
Research Domain of This Article
Surgery
Article-Type of This Article
Letter to the Editor
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastroenterol. Jun 28, 2025; 31(24): 104907 Published online Jun 28, 2025. doi: 10.3748/wjg.v31.i24.104907
Approaches to laparoscopic anatomic liver resection: Does one size fit all?
Dhiraj John Sonbare
Dhiraj John Sonbare, Department of Hepato-Pancreato-Biliary Surgery, Christian Medical College, Ranipet Campus, Ranipet 632517, Tamil Nādu, India
Author contributions: Sonbare DJ reviewed the manuscript on invitation and commented on the article.
Conflict-of-interest statement: The author has no conflict of interest to disclose.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Dhiraj John Sonbare, MD, Associate Professor, Department of Hepato-Pancreato-Biliary Surgery, Christian Medical College, Ranipet Campus, Ranipet 632517, Tamil Nādu, India. djsonbare@gmail.com
Received: January 8, 2025 Revised: April 14, 2025 Accepted: June 3, 2025 Published online: June 28, 2025 Processing time: 169 Days and 15.3 Hours
Abstract
Various approaches to laparoscopic anatomic liver resection have been described. In this paper, the authors present a technique that utilizes the ventral avascular areas above the inferior vena cava. While many liver surgeons partially adopt this elements of this method, few employ it to the full extent outlined here. Maintaining low central venous pressure during anesthesia is critical to this approach, as demonstrated by the operative images showing collapsed hepatic veins. This technique is particularly advantageous when the patient’s body mass index is low, the tumor is small (or large but deeply embedded within the liver parenchyma), and the overlying liver tissue is not excessively bulky or heavy. Nonetheless, following the conventional course along the Glissonean pedicle can be beneficial. The authors demonstrate notable skill in completing these procedures laparoscopically. However, concerns over margin positivity and tumor recurrence remain, and follow up studies are needed to further validate the approach.
Core Tip: Different approaches to laparoscopic anatomic liver resection have been described. The authors describe an approach using the ventral avascular areas above the inferior vena cava, which requires a skillful laparoscopic surgeon. However, concerns over margin positivity and tumor recurrence remain, and follow up studies are necessary to validate the approach.
