Ricerc@Sapienza

I read with great interest the excellent
article ‘‘The Impact of Different Surgical
Techniques on Outcomes in Laparoscopic
Sleeve Gastrectomies’’1 from Berger et al,
published in the September 2016 issue of
Annals of Surgery. The role of the impact
of different technical details on the outcome
of sleeve gastrectomies is particularly
relevant, and several aspects pointed out by
the authors certainly deserve the maximum
attention of the international bariatric
surgical community.

Associating liver partition with portal vein ligation for staged hepatectomy (ALPPS) represents a new surgical technique for the resection of advanced hepatic malignancies with predicted insufficient future liver remnant. In some patients, ALPPS can be associated with an increased risk of poor outcomes. Minimally invasive surgery (MIS) has been proposed in combination with ALPPS with the intent to minimize this risk. We systematically evaluated the outcomes of MIS-ALPPS cases to compare the relative outcomes of open ALPPS versus MIS-ALPPS.