Добавил:
Sekretar
kiopkiopkiop18@yandex.ru
t.me/Prokururor I Вовсе не секретарь, но почту проверяю
Опубликованный материал нарушает ваши авторские права? Сообщите нам.
Вуз:
Предмет:
Файл:Ординатура / Хирургия / @xirurgi_2025 / @xirurgi_2025 - 662 - файл
.pdf
Glissonean Pedicles
Approach in
Minimally Invasive
Liver Surgery
Benedetto Ielpo
Edoardo Rosso
Alessandro Anselmo
Editors
Foreword by
Atsushi Sugioka
123
Glissonean Pedicles Approach
in Minimally Invasive Liver Surgery
Benedetto Ielpo
Edoardo Rosso • Alessandro Anselmo
Editors
Glissonean Pedicles
Approach in Minimally
Invasive Liver Surgery
Editors
Benedetto Ielpo
HPB Surgery Unit
Department of Surgery
Hospital Del Mar
Barcelona, Spain
Alessandro Anselmo
HPB Surgery and Transplants Unit
Department of Surgery
Policlinico Tor Vergata
Rome, Italy
Edoardo Rosso
Service de Chirurgie Gènèrale
Department of General, Mini-Invasive
and Robotic Surgery
Centre Hôspitalier du Luxembourg
Luxembourg City, Luxembourg
ISBN 978-3-031-35294-2 ISBN 978-3-031-35295-9 (eBook)
https://doi.org/10.1007/978-3-031-35295-9
© The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature
Switzerland AG 2023
This work is subject to copyright. All rights are solely and exclusively licensed by the Publisher,
whether the whole or part of the material is concerned, specically the rights of translation,
reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microlms or in any
other physical way, and transmission or information storage and retrieval, electronic adaptation,
computer software, or by similar or dissimilar methodology now known or hereafter developed.
The use of general descriptive names, registered names, trademarks, service marks, etc. in this
publication does not imply, even in the absence of a specic statement, that such names are
exempt from the relevant protective laws and regulations and therefore free for general use.
The publisher, the authors, and the editors are safe to assume that the advice and information in
this book are believed to be true and accurate at the date of publication. Neither the publisher nor
the authors or the editors give a warranty, expressed or implied, with respect to the material
contained herein or for any errors or omissions that may have been made. The publisher remains
neutral with regard to jurisdictional claims in published maps and institutional afliations.
This Springer imprint is published by the registered company Springer Nature Switzerland AG
The registered company address is: Gewerbestrasse 11, 6330 Cham, Switzerland
Paper in this product is recyclable.
Foreword
https://t.me/medicina_free
This book covers liver surgery of the Glissonean pedicles, particularly in the
context of minimally invasive liver resections (MILRs), its history, and the
detailed surgical techniques. The editors are very experienced HPB surgeons
from three prestigious European HPB centers and have the great merit to have
put together some of the best experts worldwide that have covered all the
aspects of this “new” approach to liver surgery. From history to anatomy,
ending with detailed description of pedicle isolation for each type of hepatectomy, this work is a beautiful journey through the universe of anatomical liver
resections.
The main concept behind this approach is that to standardize MILR, it is
necessary to establish techniques to control the Glissonean pedicles that will
enable not only to avoid complications, but also to remove the optimal amount
of liver parenchyma. This technique is called “anatomic liver resection” and
is fundamental for all types of liver resection and known to provide safe and
favorable outcomes. However, many surgeons are not familiar with the
Glissonean pedicle approach and anatomic liver resection in MILR at present. This very-well-written volume is the rst one that is entirely focused on
Glissonean pedicle approach and will be extremely useful for the current and
the next generation of liver surgeons, helping them to handle with the
Glissonean pedicles.
Couinaud proposed various approaches to the Glissonean pedicles, as follows: (1) intrafascial approach, (2) extrafascial approach, and (3) extrafascial
and major ssural approach. The intrafascial approach means individual vascular dissection, whereas the extrafascial approach is Glissonean pedicle isolation in a broad sense. The extrafascial approach is further divided into two
categories: one without liver parenchymal destruction, and the other with
minor liver transection. The former is an extrahepatic Glissonean pedicle
approach.
We have demonstrated the comprehensive and precise anatomy of the liver
based on Laennec’s capsule that is a true membrane of the liver described by
Laennec in 1802, which was ignored for more than 200 years. The technique
of extrahepatic Glissonean pedicle isolation will come into practical use via
“the gate theory.” This means that the gaps between Laennec’s capsule and
the Glissonean pedicle can only be entered through the six gates dened by
the four anatomical landmarks (the Arantius plate, umbilical plate, cystic
plate, and pedicle of the caudate process (G1c)), and approach to the desired
gate enables us to isolate any extrahepatic Glissonean pedicle at will.
v
vi
https://t.me/medicina_free
The remaining issue of MILR is to establish a technique to control the
hepatic vein. This is nearing completion owing to the fact that the Laennec’s
capsule also exists surrounding the hepatic vein and that is composed of two
layers, as revealed by Monden and Kiguchi. All the aforementioned concepts
are very well described and deepened throughout the pages of this book that
will contribute to broadening of the knowledge of the Glissonean approach
and to establishing of safe and curative MILR.
International Medical Center AtsushiSugioka
Fujita Health University Hospital
Aichi, Japan
Foreword
Preface
https://t.me/medicina_free
Great is the fortune of he who possesses a good bottle, a good book, and a good
friend—(Molière).
As often happens, great ideas are conceived in a moment of relaxation, in
company of sincere friends and in front of a good glass of wine.
Same for this book, which came to life from a common intuition, on a
sunny day in June 2021.
Three friends, three hepatobiliary surgeons, meet in Barcelona, Spain, for
surgical training in liver resections. They discover that for all this time, they
have all been studying the same technique for hepatic resections coming from
the East: “the Glissonean approach to hepatic pedicles.” They are passionate
and thus was born the idea of sharing with the scientic community the latest
notions on this fascinating and relatively new method (at least for the Western
community) to perform anatomical liver resections in the context of minimally invasive surgery. Friends soon become many more. This volume is, in
fact, the result of the work of some of the most talented Italian and European
hepatobiliary surgeons, plus some from the well-known Japanese school. An
experienced surgeon, like a young one, will nd in this book some new concepts on Glissonean anatomy of the liver based on the Laennec’s capsule,
precious notions of intraoperative ultrasound for the identication of biliovascular pedicles, details of minimally invasive surgery techniques, and
numerous and valuable expert’s “tips and tricks” to be applied to each hepatic
segment to be resected. A large set of surgical videos available online complete this work, which we invite you to savor slowly, just like sipping a good
glass of wine.
Special thanks go to all the friends and authors who have given their valuable contribution, and our warm appreciation goes to Professor A.Sugioka,
pioneer of this technique, who honored us with his enlightening foreword.
Rome, Italy AlessandroAnselmo
Barcelona, Spain BenedettoIelpo
Luxembourg, Luxembourg EdoardoRosso
vii
Contents
https://t.me/medicina_free
Part I Overview
1 The History of Glissonean Approach: From
Takasaki to PAM Consensus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Alessia Fassari, Vito de Blasi, and Edoardo Rosso
2 Glissonean Pedicles, Landmarks, and Gates . . . . . . . . . . . . . . . . 7
Alessandro Anselmo, Leandro Siragusa, Bruno Sensi,
and Giuseppe Tisone
3 Intraoperative Ultrasound Pedicle Localization . . . . . . . . . . . . . 21
Alessandro Ferrero, Roberto Lo Tesoriere,
and Nadia Russolillo
4 Main Instruments for Hepatic Transection and Minimally
Invasive Pedicle Dissection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
Fernando Burdio, Soa Jaume-Bottcher,
Patricia Sánchez-Velázquez, and Benedetto Ielpo
5 Glissonean Pedicles for Liver- Sparing Parenchymal
Resection Lesson Learned from Open Surgery . . . . . . . . . . . . . . 39
Fabio Procopio and Guido Torzilli
6 Anatomic Versus Nonanatomic Resection . . . . . . . . . . . . . . . . . . 55
Umberto Cillo, Andrea Marchini, Francesco Enrico D’Amico,
and Enrico Gringeri
7 Trocars and Patient Position . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 59
Gemma Bosch Silvela and Patricia Sánchez-Velázquez
Part II Anatomical Approach Glissonean Pedicles (Left Liver)
8 Segment I Hepatectomy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69
Gianluca Cassese and Roberto Ivan Troisi
9 Segment II Hepatectomy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 75
Riccardo Memeo
10 Segment III Hepatectomy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 79
Gabriella Pittau and Daniel Cherqui
ix
x
https://t.me/medicina_free
11 Segment IV Hepatectomy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 85
Francesco Ardito, Caterina Mele, Francesco Razionale,
and Felice Giuliante
12 Left Lateral Bisegmentectomy . . . . . . . . . . . . . . . . . . . . . . . . . . . . 91
Giammauro Berardi, Germano Mariano, Marco Colasanti,
Roberto Meniconi, Stefano Ferretti, Nicola Guglielmo,
Marco Angrisani, and Giuseppe Maria Ettorre
13 Left Hemihepatectomy (Segment II + III + IV) . . . . . . . . . . . . . . 97
Benedetto Ielpo, Mark Yeo Hao Xuan,
Maria Alejandra Guerrero, and Leandro Siragusa
Part III Anatomical Approach Glissonean Pedicles (Right Liver)
14 Laparoscopic Anatomical Resection of Segment VI
of the Liver . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 105
Darren W. Q. Chua, Yoshio Masuda, and Koh Ye Xin
15 Segment VII Hepatectomy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 111
Felice Giuliante, Francesco Ardito, and Francesco Razionale
16 Segment VIII Hepatectomy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 117
Julio Santoyo-Santoyo, Julio Santoyo-Villalba,
María Pérez-Reyes, and Belinda Sánchez-Pérez
Contents
17 Right Posterior Hepatectomy (Segment VI + VII) . . . . . . . . . . . . 125
Ruben Ciria, Blanca Ruán, María Dolores Ayllón,
and Javier Briceño
18 Right Anterior Hepatectomy (Segment V + VIII) . . . . . . . . . . . . 129
Mikel Gastaca, Arkaitz Perfecto, and Mikel Prieto
19 Right and Right Extended Hemihepatectomy . . . . . . . . . . . . . . . 135
Ratti Francesca, Marino Rebecca, Clocchiatti Lucrezia,
Catena Marco, and Aldrighetti Luca
20 Mesohepatectomy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 145
Celia Caula, Margarida Casellas, and Santiago López-Ben
Part IV Special Subjects
21 How to Prevent Pitfalls . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 151
Alessia Fassari, Edoardo Rosso, and Vito De Blasi
22 The Use of Indocyanine Green and Near-Infrared
Fluoroscopy for Glissonean Approach . . . . . . . . . . . . . . . . . . . . . 155
Taiga Wakabayashi, Marco Colella, Giammauro Berardi,
and Go Wakabayashi
Contents
https://t.me/medicina_free
xi
23 The Use of 3D Virtual Surgical Planning . . . . . . . . . . . . . . . . . . . 161
Emilio Vicente, Yolanda Quijano, Valentina Ferri,
and Riccardo Caruso
24 Robotic Versus Laparoscopy Approach for Glissonean
Pedicle Dissection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 165
Mathieu D’Hondt and Dennis A. Wicherts
Соседние файлы в папке @xirurgi_2025