Background : We will present our surgical experience about single port laparoscopic left hemihepatectomy. The patient was suffered from abdominal pain due to intrahepatic duct stones.

Methods : We made a 2.5cm-sized vertical umbilical incision for single-port. A 10mm 3D flexible telescope and conventional laparoscopic instruments were applied. . At first, cystic duct and artery were isolated and ligated with hem-o-loks. The energy device was also used for dissection. After gallbladder was detached from the liver, the falciform ligament was detached from the abdominal wall. There were adhesions between the liver and the surrounding tissues. The falciform ligament was tied and was used for traction through the transperitoneal approach. The hepatic artery was identified and isolated. The hepatic artery was ligated with hem-o-loks and divided. The snake retractor was used for liver elevation. The left-sided hilum was dissected for ligating left hepatic artery and left portal vein. During manipulation of liver, there was some bleeding from the portal vein of the liver side, which was controlled by the clips.

Results : After inflow control for hepatic artery and portal vein, we demarcated the line along the color change of liver parenchyma. After identification of color change of liver, the traction suture was applied on the right liver, which was used for traction through the transperitoneal approach. The liver dissection was performed by ultrasonic energy device. The veins and ducts were ligated with hem-o-loks. Left hepatic vein was ligated with the vascular stapler. The specimens were removed through the Pfannenstiel incision. The drain was located in the single-port through the umbilical incision.

Conclusions : Single-port laparoscopic left hemihepatectomy was safe and feasible surgical approach in selected patients.