Research progress of standardized laparoscopic segmentectomy based on Laennec's capsule theory
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1.Department of Hepatobiliary, Pancreatic and Splenic Surgery, Ningde Municipal Hospital, Ningde Normal University, Ningde, Fujian 352100, China;2.Ningde Clinical Medicine College of Fujian Medical University, Ningde, Fujian 352100, China

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R657.3

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    Abstract:

    With the rapid development of laparoscopic liver surgery, laparoscopic hepatectomy has gradually become a mainstream procedure in liver surgery, and the anatomical understanding of the liver membrane plays a crucial role in this. The Laennec's capsule encapsulates the entire liver. It enters the liver parenchyma along with the Glisson's capsule and hepatic veins, separating the liver parenchyma from the Glisson's capsule, "six portal triads" system, hepatic veins, and the retrohepatic inferior vena cava. It is the standard intermembrane space for safe dissection and location of the hepatic pedicle during hepatectomy. Accurate liver tissue resection can be achieved by separating the Glisson's capsule that enters the liver and the hepatic veins that exit the liver through the Laennec's capsule. Currently, there is a scarcity of literature strictly adhering to the standard laparoscopic liver segmentectomy, and even fewer studies report on laparoscopic liver segmentectomy combined with Laennec's membrane anatomy. Histology has confirmed the existence of the Laennec's membrane, which is independent and not continuous with the Glisson's capsule at the hepatic hilum; there is a space between them that deepens into the liver parenchyma along with the Glisson's capsule. Utilizing the space between the Glisson's capsule at the hepatic hilum and the Laennec's capsule to separate and ligate the Glisson's capsule of each liver segment provides the anatomical basis for standardized liver segmentectomy. This paper summarizes relevant research on the theory of Laennec's capsule, combined with clinical exploration reports on laparoscopic segmental hepatectomy, to provide a reference for standardized laparoscopic liver segmentectomy based on Laennec's capsule.

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LIN Dexin, CHANG Guijian, ZHUO Xinbin, LEI Wendi, ZHANG Yong, LI Xuan. Research progress of standardized laparoscopic segmentectomy based on Laennec's capsule theory[J]. Chin J Gen Surg,2024,33(7):1153-1161.
DOI:10.7659/j. issn.1005-6947.2024.07.014

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History
  • Received:June 13,2024
  • Revised:July 15,2024
  • Adopted:
  • Online: August 10,2024
  • Published: