Hasegawa et al reported a model for predicting the surgical difficulty of performing a pure laparoscopic liver resection. The authors are from Iwate Medical University and Ageo Central General Hospital in Japan.
Patient selection: pure laparoscopic liver resection
Parameters:
(1) extent of the resection
(2) location of tumor (Couinaud segment)
(3) obesity based on body mass index (BMI)
(4) platelet count
Parameter
Finding
Points
extent of resection
non-anatomical, left lateral sectionectomy
0
anatomical segmentectomy
2
major hepatectomy
3
location of tumor
S2/S3/S4
0
S5/S6
1
S7/S8
2
obesity (BMI)
< 30 kg per sq m
0
>= 30 kg per sq m
1
platelet count
> 100 * 10^9/L
0
<= 100 * 10^9/L
1
total score =
= SUM(points for all of the parameters)
Interpretation:
• minimum score: 0
• maximum score: 7
• The higher the score the greater the surgical time, blood loss, length of hospital stay and morbidity.
Total Score
Surgical Difficulty
0 or 1
low
2 or 3
medium
4 to 7
high
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