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Thiruchelvam et al. Hepatoma Res 2021;7:22 Hepatoma Research
DOI: 10.20517/2394-5079.2020.144

Perspective Open Access

Patient and port positioning in laparoscopic liver
resections

Nita Thiruchelvam , Ser Yee Lee , Adrian Kah Heng Chiow 1
1
2,3
1 Department of General Surgery, Hepatopancreatobiliary Service, Changi General Hospital, Singapore 529889, Singapore.
2 Department of Hepatopancreatobiliary and Transplant Surgery, Singapore General Hospital, Singapore 169608, Singapore.
3 Surgical Associates, Mount Elizabeth Medical Centre, Singapore 228510, Singapore.

Correspondence to: Dr. Nita Thiruchelvam, Department of General Surgery, Hepatopancreatobiliary Service, Changi General
Hospital, 2 Simei Street 3, Singapore 529889, Singapore. E-mail: thiruchelvam.nita@singhealth.com.sg
How to cite this article: Thiruchelvam N, Lee SY, Chiow AKH. Patient and port positioning in laparoscopic liver resections.
Hepatoma Res 2021;7:22. http://dx.doi.org/10.20517/2394-5079.2020.144
Received: 9 Nov 2020 First Decision: 24 Dec 2020 Revised: 17 Jan 2021 Accepted: 29 Jan 2021 Published: 12 Mar 2021

Academic Editors: Ho-Seong Han, David Geller Copy Editor: Yue-Yue Zhang Production Editor: Xi-Jun Chen

Abstract
Received: First Decision: Revised: Accepted: Published:
Currently, laparoscopic liver resections are routinely performed at an increasing number of centres and has
Science Editor: Copy Editor: Production Editor: Jing Yu extended to include major liver resections as well as more challenging segments of the liver. We believe that
patient positioning and port placement is a critical yet under described component of successful laparoscopic
liver resection to achieve optimal visualisation and allow for an ergonomic and safe dissection. In this article, we
describe the advantages of various types of patient positioning as well as provide illustrations for an array of trocar
configurations previously described in literature. Whilst there is no universally accepted standardization of port
placement for various resection types, this descriptive article can serve as a guide for the various possibilities of
port configurations that can be individually adapted by surgeons based on their preference as well as the patient’s
physique and anatomy.

Keywords: Laparoscopic liver resection, port positioning, patient positioning

INTRODUCTION
In the first and second international consensus conference held in Louisville and Morioka in 2008 and 2014
respectively, minor laparoscopic liver resections (LLR) were acknowledged to be the standard of care and
[1,2]
major resections were deemed to be in the exploratory phase . Since then, with improved technology,
increased surgical experience, and introduction of novel techniques, an international survey revealed

© The Author(s) 2021. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use,
sharing, adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as long
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