Published online Jan 15, 2020. doi: 10.4251/wjgo.v12.i1.77
Peer-review started: July 3, 2019
First decision: July 31, 2019
Revised: August 24, 2019
Accepted: September 26, 2019
Article in press: September 26, 2019
Published online: January 15, 2020
Processing time: 182 Days and 1 Hours
Diagnosis of lympho-proliferative diseases is challenging. Although an excisional biopsy of a complete lymph node is the gold standard for diagnosis, endoscopic or percutaneous techniques are often used due to the surgical challenge the location of the lymph node imposes.
The current study describes a small case series of laparoscopic dissection of the hepatic node through a trans lesser omentum approach. This approach is rarely discussed in the English literature.
The study describes the clinical and surgical results of this novel technique.
A single center, retrospective evaluation of patients undergoing laparoscopic dissection and excisional biopsy of the hepatic node.
During the time frame of the study, six patients were operated using this novel technique, with no conversions to laparotomy, no intra and post-operative complications and acceptable operating time. Most importantly, surgery yielded a definite diagnosis in all patients, and there was no need for further investigation.
Laparoscopic dissection of the hepatic node seems to be feasible and safe, and surgeons may use this simple approach to a fairly complicated anatomical area in highly selected patients who do not have access to superficial lymph nodes.
This study suggests that approach to the hepatic node and the celiac axis is easily and safely performed through a trans lesser omentum approach. This may facilitate future discussion on how to achieve the diagnosis of lympho-proliferative disease in patients who do not have enlarged and pathological superficial lymph nodes.