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World J Gastroenterol. Jul 21, 2022; 28(27): 3359-3369
Published online Jul 21, 2022. doi: 10.3748/wjg.v28.i27.3359
Single-incision laparoscopic surgery to treat hepatopancreatobiliary cancer: A technical review
Shu-Hung Chuang, Shih-Chang Chuang
Shu-Hung Chuang, Shih-Chang Chuang, Division of General and Digestive Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
Shu-Hung Chuang, Shih-Chang Chuang, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan
Author contributions: Chuang SH drafted the manuscript; Chuang SC revised the manuscript; Both authors have read and approve the final manuscript.
Conflict-of-interest statement: The authors report no conflict of interest.
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: Shih-Chang Chuang, MD, PhD, Associate Professor, Director, Surgeon, Surgical Oncologist, Division of General and Digestive Surgery, Department of Surgery, Kaohsiung Medical University Hospital, Kaohsiung Medical University, No. 100 Shih-Chuan 1st Road, Sanmin District, Kaohsiung 80708, Taiwan. chuangsc@cc.kmu.edu.tw
Received: January 17, 2022
Peer-review started: January 17, 2022
First decision: March 9, 2022
Revised: March 20, 2022
Accepted: June 16, 2022
Article in press: June 16, 2022
Published online: July 21, 2022
Abstract

Single-incision laparoscopic surgery (SILS), or laparoendoscopic single-site surgery, was launched to minimize incisional traumatic effects in the 1990s. Minor SILS, such as cholecystectomies, have been gaining in popularity over the past few decades. Its application in complicated hepatopancreatobiliary (HPB) surgeries, however, has made slow progress due to instrumental and technical limitations, costs, and safety concerns. While minimally invasive abdominal surgery is pushing the boundaries, advanced laparoscopic HPB surgeries have been shown to be comparable to open operations in terms of patient and oncologic safety, including hepatectomies, distal pancreatectomies (DP), and pancreaticoduodenectomies (PD). In contrast, advanced SILS for HPB malignancy has only been reported in a few small case series. Most of the procedures involved minor liver resections and DP; major hepatectomies were rarely described. Single-incision laparoscopic PD has not yet been reported. We herein review the published SILS for HPB cancer in the literature and our three-year experience focusing on the technical aspects.

Keywords: Hepatectomy, Hepatopancreatobiliary cancer, Laparoendoscopic single-site surgery, Pancreatectomy, Pancreaticoduodenectomy, Single-incision laparoscopic surgery

Core Tip: Single-incision laparoscopic surgery (SILS), or laparoendoscopic single-site surgery, has been introduced to minimize incisional traumatic effects over the past few decades. As minor SILS, such as cholecystectomies, have been gaining in popularity, major SILS for complicated hepatopancreatobiliary (HPB) surgeries have made slow progress due to instrumental and technical limitations, costs, and safety concerns. We herein review the published SILS for HPB cancer in the literature and our three-year experience focusing on the technical aspects.