INTRODUCTION Laparoscopic liver resection (LLR) for tumors involving segment VII has been considered a contraindication. Herein, our proposed laparoscopic technique for segment VII lesions using a rubber band retraction method and flexible laparoscope is introduced. METHODS A combination of elastic rubber band retraction method and flexible laparoscope was applied to access segment VII lesion. The perioperative outcomes and pathologic results were compared between patients with segment VII lesions (group 1) and patients with tumors in other segments (group 2) to evaluate feasibility and safety of the proposed laparoscopic approach for segment VII lesions. RESULTS Among 167 patients who underwent LLR from May 2014 to October 2017, the study population included 17 patients with tumors in segment VII (group 1) and 66 patients with tumors in other segments (group 2). The demographics of the two groups were comparable. One open conversion occurred in group 2 due to bleeding. The mean tumor size was 2.6 ± 1.0 and 2.5 ± 1.5 cm (p = 0.392) and surgical margin was 1.2 ± 0.7 and 1.3 ± 1.2 cm (p = 0.344) in group 1 and group 2, respectively. The mean operation time was 151 ± 63 and 131 ± 57 min (p = 0.596) and estimated mean blood loss was 294 ± 281 and 306 ± 405 mL (p = 0.610), in group 1 and group 2, respectively. The mean postoperative hospital stay was 6.1 ± 1.5 and 6.4 ± 2.7 days (p = 0.064) in group 1 and group 2. Two postoperative complications in both groups and no postoperative mortality occurred. CONCLUSION The combination technique of rubber band retraction and flexible laparoscopic camera allowed feasible and safe LLR for segment VII lesions that showed postoperative outcomes comparable to other segment lesions.

中文翻译：

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结合橡皮筋牵拉法和柔性腹腔镜对VII段病变进行腹腔镜肝切除。

引言腹腔镜肝切除术（LLR）用于涉及VII节的肿瘤被认为是禁忌症。在此，介绍了我们提出的使用橡皮筋牵拉法和柔性腹腔镜对VII段病变进行腹腔镜检查的技术。方法采用弹性橡皮筋回缩法和柔性腹腔镜相结合的方法治疗第VII节段病变。比较了具有VII段病变的患者（第1组）和患有其他段肿瘤的患者（第2组）的围手术期结果和病理结果，以评估提出的腹腔镜方法治疗VII段病变的可行性和安全性。结果2014年5月至2017年10月的167例接受LLR的患者中，研究人群包括第VII节中的17例肿瘤患者（第1组）和其他节段中的66例肿瘤患者（第2组）。两组的人口统计学具有可比性。由于出血，第2组发生一次开放转换。第一组和第二组的平均肿瘤大小分别为2.6±1.0和2.5±1.5 cm（p = 0.392），手术切缘分别为1.2±0.7和1.3±1.2 cm（p = 0.344）。第一组和第二组的平均手术时间分别为151±63和131±57分钟（p = 0.596），估计平均失血量为294±281和306±405 mL（p = 0.610）。第一组和第二组的平均术后住院天数分别为6.1±1.5天和6.4±2.7天（p = 0.064），两组均发生了两种术后并发症，且无术后死亡率发生。