Biomedical subjects

Sumito Takagi

Publications and source records attributed to Sumito Takagi.

4 recordsLinked to original sources

PubMed2005

Laparoscopic liver resection of hepatocellular carcinoma.

BACKGROUND: We have continued to develop laparoscopic hepatectomy as a means of surgical therapy for hepatocellular carcinoma (HCC). METHODS: We evaluated the degree of invasiveness and analyzed the outcomes of laparoscopic hepatectomy compared with open hepatectomy for HCC. RESULTS: There were notable differences with respect to blood loss and operating time compared with open hepatectomy cases. Patients started walking and eating significantly earlier in the laparoscopic hepatectomy group, and these more rapid recoveries allowed shorter hospitalizations. On the Estimation of Physiologic Ability and Surgical Stress (E-PASS) scoring system, there was no difference in preoperative risk. However, a significant difference was seen in the surgical stress and comprehensive risk scores between the open hepatectomy and laparoscopic hepatectomy groups. Concerning the survival rate and disease-free survival rate, there were no significant differences between procedures. CONCLUSIONS: Laparoscopic hepatectomy avoids some of the disadvantages of open hepatectomy and is beneficial for patient quality of life (QOL) as a minimally invasive procedure if the operative indications are appropriately based on preoperative liver function and the location and size of HCC.

Aged↗

PubMed2004

Laparoscopy-assisted spleen-preserving distal pancreatectomy with conservation of the splenic artery and vein.

Herein, we report the successful performance of a laparoscopy-assisted spleen-preserving distal pancreatectomy with conservation of the splenic artery and vein for a patient with pancreatic cystadenoma, as a minimally invasive procedure with the preservation of function. The laparoscopy-assisted distal pancreatectomy procedure involved detaching the spleen and the distal pancreas from the retroperitoneum by a hand-assisted procedure, removing them from the peritoneal cavity through a small incision, and detaching the distal pancreas by ligating and transecting the short gastric artery and vein and the branches of the splenic artery and vein, while the spleen and main splenic artery and vein were preserved under direct view. The pancreatic parenchyma was transected with a stapling device (TL-30), and continuous suturing was added to the resected margin. The patient's postoperative course was uneventful; the patient started to eat and walk on postoperative day 2 and was discharged on day 8. It is considered that the combination of hand-assisted and laparoscopy-assisted distal pancreatectomy, with conservation of the splenic artery and vein, is a minimally invasive and clinically useful technique for treating tumors of cystic disease of the pancreas with low-grade malignant potential, or benign solitary neuroendocrine tumors.

Adult↗

PubMed2004

Hepatic resection using stapling devices.

BACKGROUND: The progress and development of stapling devices has been remarkable. They have become indispensable for gastrointestinal diseases and are increasingly utilized in laparoscopic operations. Liver surgery applications for this technique are continuing to emerge, and in this study, we introduced the use of stapling devices to hepatic surgery. METHODS: We examined the operative procedure and efficacy of hepatic resections using stapling devices as follows: transection of Glisson's pedicle and the hepatic vein using endolineal stapling devices in right and left lobectomies; bisegmentectomy II and III en masse using a stapling device; and application of endolineal stapling devices to vessel transections and dissections of the hepatic parenchyma in laparoscopic hepatectomies. RESULTS: It was considered useful to tactfully apply stapling devices to vessel transections and dissections of the hepatic parenchyma in order to simplify the operative procedures of right or left lobectomies and lateral segmentectomies. Furthermore, the use of endoscopic stapling devices was an acceptable alternative to vessel transactions and dissections of the hepatic parenchyma in laparoscopic hepatectomies. CONCLUSIONS: We believe that stapling devices will become utilized in liver surgery hereafter.

Hepatectomy↗

PubMed2002

[The current state of laparoscopic surgery for abdominal parenchymatous organs].

Laparoscopic surgery for abdominal parenchymatous organs such as the liver and pancreas presents unique technical challenges and anatomic difficulties although laparoscopic splenectomy has become the standard procedure in some hospitals. The advances in laparoscopic technology have encouraged expert hands to extend the procedure to parenchymatous organs. Clinical cases of laparoscopic hepatectomy, as well as laparoscopic thermal ablation, for patients with hepatic tumor have been increasing recently. The most important considerations for laparoscopic hepatectomy are the clinical characteristics of the tumor. Tumors that are smaller than 5 cm and located in the lower or left lateral segment are good candidates. At present, partial hepatectomy and left lateral segmentectomy are appropriate operative procedures. The laparoscopic approach is considered the treatment of choice, as it is less invasive in selected patients. Laparoscopic pancreatectomy is difficult to evaluate at present because of the scarcity of clinical cases. Laparoscopic pancreatectomy is indicated for distal, enucleated tumors. Another procedure, pancreatic cystogastrostomy, utilizes an intragastric approach. Laproscopic splenectomy will be the standard procedure in patients suffering hematologic disease, although it remains controversial in cases of splenomegaly due to the possibility of portal hypertension or hematologic malignancy. The incidence of conversion to open laparotomy due to uncontrollable bleeding is closely related to the technical skill of the surgeon. Safer laparoscopic procedures for abdominal parenchymatous organs depends on further refinement of endoscopic technology and improved training in endoscopic techniques.

Hepatectomy↗