“Mini-Laparoscopy Liver Biopsy Technique”—Experimental group (
CAVITY, DECUBITUS, PNEUMOPERITONEUM
The surgical technique consists of (Fig. Patient lying in the horizontal dorsal decubitus position under general anesthesia;Asepsis, antisepsis and apposition of surgical drapes;Supra-umbilical arcuate incision; dieresis by planes; opening of the aponeurosis and passage of the 10-mm trocar, followed by creation of pneumoperitoneum using the open technique;30° optical trocar apposition and cavity inventory;Device insertion in the right hypochondrium, 1.0 cm below the right costal margin, in the midclavicular line, forming a 90º angle with the skin;The needle is removed from the device and the silicone is maintained;Placement of the cocked biopsy needle inside the device silicone strut, which is fired for the biopsy (Fig. The biopsy fragment is removed and the needle is reintroduced;The needle is kept in contact with the biopsy site and tissue cauterization is performed by touching the monopolar electric scalpel to the device needle (there is no transmission to the skin, subcutaneous tissue or muscle, as the device has electrical insulation);Review of hemostasis and count of the material used during surgery.Trocar and device insertion sites in the mini-laparoscopy technique. Sub-figure labelling: On the left, schematically the larger circle represents the 10 mm trocar of the optics and the smaller circle represents the puncture point with the suggested device. On the right, follows the equivalent location in the surgical actSteps performed to obtain the liver parenchyma biopsy specimen using a Trucut needle. A The needle is removed from the Jelco® and the silicone is maintained; (B) The Trucut needle is placed through the silicone strut; (C) Use of the Trucut needle to obtain the biopsy material; (D) Detail of the obtained fragment measuring 02 cm