Role of intercostal trocars on laparoscopic liver resection for tumors in segments 7 and 8

  Performing laparoscopic liver resection for lesions located in segment 7 and 8 is technically difficult, as the operative field is far from the conventional trocar site, and the liver impedes free motion of the laparoscopic instrument. Inserting the port through the intercostal space ( ICS ) may facilitate liver resection for these lesions. From J anuary 2012 to J uly 2013, five patients (four men and one woman) underwent laparoscopic S7 or 8 segmentectomy for liver metastasis and hepatocellular carcinoma ( HCC ). Ports were inserted at the 7th and 9th ICS , respectively, in addition to conventional abdominal ports. The mean age was 58 ± 10 (45–74) years; operation time, 197 ± 68 (110–300) minutes; blood loss, 161 ± 138 (40–320) ml; and length of hospital stay, 7 ± 3 (4–12) days. Pathologic findings revealed three, one, and one case(s) of colon cancer metastasis, breast cancer metastasis, and HCC , respectively. The mean tumor size and tumor‐free margin were 2.2 ± 1.1 cm and 5.8 ± 1.9 mm, respectively. There were no postoperative complications. Laparoscopic liver resection using intercostal trocars could be a useful method for tumors located in segments 7 and 8 of the liver in selected patients.