Development Process and Technical Aspects of Laparoscopic Hepatectomy: Learning Curve Based on 15 Years of Experience Shohei Komatsu, MD, PhD, FACS,

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Development Process and Technical Aspects of Laparoscopic Hepatectomy: Learning Curve Based on 15 Years of Experience Shohei Komatsu, MD, PhD, FACS, Olivier Scatton, MD, PhD, Claire Goumard, MD, Ailton Sepulveda, MD, PhD, Raffaele Brustia, MD, Fabiano Perdigao, MD, Olivier Soubrane, MD, PhD Journal of the American College of Surgeons Volume 224, Issue 5, Pages 841-850 (May 2017) DOI: 10.1016/j.jamcollsurg.2016.12.037 Copyright © 2017 American College of Surgeons Terms and Conditions

Figure 1 Installation and trocar positioning. Trocar positioning when the tumor is located to the left (A) and to the right (B) of Cantlie's line. (Reprinted courtesy of the artist, Raffaele Brustia, MD). Journal of the American College of Surgeons 2017 224, 841-850DOI: (10.1016/j.jamcollsurg.2016.12.037) Copyright © 2017 American College of Surgeons Terms and Conditions

Figure 2 Chronological trends for (A) each procedure and (B) each indication during the study period. BBT, benign-borderline tumor; HCC, hepatocellular carcinoma; Hx, hepatectomy; LD, living donor; LLS, left lateral sectionectomy. Journal of the American College of Surgeons 2017 224, 841-850DOI: (10.1016/j.jamcollsurg.2016.12.037) Copyright © 2017 American College of Surgeons Terms and Conditions

Figure 3 Incidence rates of conversion to open surgery and major complications for each procedure. (A) Left lateral sectionectomy; (B) left hepatectomy; (C) right hepatectomy. Blue bar, early group; red bar, late group. Journal of the American College of Surgeons 2017 224, 841-850DOI: (10.1016/j.jamcollsurg.2016.12.037) Copyright © 2017 American College of Surgeons Terms and Conditions