Innovation in keyhole liver surgery

Department of Surgery at the Universitätsklinikum Erlangen establishes new surgical procedure

Paula V. (59) from Erlangen is the tenth patient to have benefited from the new surgical method at the Department of Surgery (Director: Prof. Dr. Dr. h. c. Werner Hohenberger) at Erlangen University Hospital. A fox tapeworm had damaged her liver. During a routine check-up, a calcified liver cyst was discovered and had to be removed recently. A surgical team under the direction of Prof. Dr. Roland Croner removed the diseased parts of the liver (liver resection) with a laparoscopic surgical method Prof. Dr. Croner had been introduced to in New York and Paris, and which was now used in the Nuremberg Metropolitan Region for the first time. After only one week, Paula V. was discharged from the hospital.

Paula V. (59) from Erlangen is the tenth patient to have benefited from the new surgical method at the Department of Surgery (Director: Prof. Dr. Dr. h. c. Werner Hohenberger) at Erlangen University Hospital. A fox tapeworm had damaged her liver. During a routine check-up, a calcified liver cyst was discovered and had to be removed recently. A surgical team under the direction of Prof. Dr. Roland Croner removed the diseased parts of the liver (liver resection) with a laparoscopic surgical method Prof. Dr. Croner had been introduced to in New York and Paris, and which was now used in the Nuremberg Metropolitan Region for the first time. After only one week,
Paula V. was discharged from the hospital.

Liver resections were previously carried out the conventional way at the University Hospital: through a long abdominal incision, the liver is exposed and operated upon. Several years ago, a method for carrying out liver resections via keyhole surgery was developed in the world’s leading centres for minimally invasive surgery, Paris and New York. In this method, four openings of a maximum size of 1 cm are created in the upper abdomen, through which endoscopes and surgical instruments are inserted into the body. The excised liver tissue is then removed via a further tiny incision above the pubic bone, in the same place incisions for Caesarean sections are made. Several studies prove that the new surgical method has no disadvantages in comparison to the conventional method. ‘On the contrary: patients lose less blood during the operation, healing is less impaired and there is hardly any pain,’ says Prof. Croner. ‘As the wounds are sealed with surgical glue instead of sutured, there are no more stitches that need taking out. The relatively small incisions heal quite rapidly and leave behind very little and hardly visible scarring,’ Prof. Croner explains. Patients are generally able to leave the hospital within a week after the procedure.

Improved quality of life for patients – Erlangen heads international study group to establish the procedure

The conditions for introducing the new procedure at FAU’s University Hospital were favourable: there are surgeons at the Department of Surgery with many years of experience in liver surgery, with state-of-the-art imaging procedures being also available. This is an important point, since the liver is home to several large blood vessels that must not be damaged during the removal of tissue. To ensure this, the Department co-operates with the Institute of Radiology (Director: Prof. Dr. Michael Uder) to precisely map out the liver’s anatomy through CT and MRI analysis of the abdomen. ‘This allows us to plan exactly how and along which layers of the liver the diseased tissue is to be removed,’ says Prof. Croner. During the operation, laparoscopic ultrasound footage of the liver is transmitted in order to determine the exact location of the liver tumours; these can then be excised completely while ensuring optimal protection of the healthy tissue. ‘The laparoscopic methods are even suitable for patients who have undergone open surgery,’ says Prof. Croner. In order to discuss the new, minimally invasive method of liver surgery and promote its establishment in hospitals, Prof. Croner has recently founded an international research group together with colleagues from New York and Paris.

Further information on the liver consultation hour at the University Hospital’s Department of Surgery: Phone: +49 (0)9131 85 33100 (Secretary: Mondays and Wednesdays, 8 a.m.–1 p.m.)

More information:

uni | media service | news No. 184/2012 on 16.8.2012