Application of a self-made liver suspension device in 3D laparoscopic non-anatomical resection of liver segment VI and VII tumors.

Abstract

Objective: To evaluate the efficacy of a novel self-designed liver suspension device in three-dimensional (3D) laparoscopic non-anatomical (NAR) resection for tumors in hepatic segments VI and VII.

Methods: Clinical records of 79 patients undergoing NAR resection of hepatic segments VI and VII at the Second Hospital of Hebei Medical University (June 2016-December 2021) were retrospectively reviewed. Patients were stratified into the Suspension Device Laparoscopic Group (SDLG), utilizing the self-designed suspension device for 3D-guided resection, and the Conventional Laparoscopic Group (CLG). Statistical analyses comprised two-sample t-tests, chi-square tests, and Log-rank tests. Perioperative outcomes including surgical time, hepatic pedicle occlusion time, intraoperative blood loss, postoperative hospital stay, drainage tube removal time, time to ambulation, postoperative flatus recovery, and complications (pleural effusion, ascites, bile leakage, wound infection/liquefaction/effusion) were compared. Postoperative hepatic functional recovery (Child-Pugh classification) and 1-/3-year survival rates were assessed.

Results: The SDLG demonstrated significantly shorter surgical time, reduced intraoperative blood loss, and abbreviated hepatic pedicle clamping time compared to the CLG. Postoperative hepatic functional recovery, as assessed by Child-Pugh classification, was accelerated in the SDLG cohort, with a higher proportion achieving baseline function earlier than the CLG. Complication rates, including pleural effusion, ascites, and bile leakage, were markedly lower in the SDLG, while no significant differences were observed in hospitalization duration, ambulation initiation, or flatus recovery. Survival analysis revealed the 1-/3-year survival rate of SDLG was higher than that of CLG.

Conclusion: The self-designed liver suspension device enhances the safety and efficiency of 3D laparoscopic NAR resection for hepatic segment VI and VII tumors by minimizing operative trauma, reducing mechanical injury risks, and promoting postoperative hepatic functional recovery. Its application is associated with fewer procedure-related complications to conventional techniques, and increased survival rate. These advantages underscore its potential as a valuable innovation in minimally invasive liver surgery, meriting further clinical validation and integration with complementary technologies to refine surgical precision and outcomes.