Introduction : A totally laparoscopic approach for associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) was rare because of surgical difficulty compared to open ALPPS approach.

Methods : A 58-year-old man with abrupt enlarging hepatic mass in the right lobe had small remnant liver volume. Estimated remnant liver volume was 23%. During the first stage of ALPPS, the liver parenchyma was transected by energy device. The second stage of ALPPS was performed 7 days later.

Results : He underwent right hepatectomy. Operative time was 200 min for the first stage of ALPPS and 98 min for the second stage. Remnant liver volume increased 52.7% compared baseline remnant liver volume. Intraoperative blood loss in first stage and second stage of ALPPS was 200 mL and 150 mL, respectively. No postoperative complications were observed. The patient was discharged 3 days after the second surgery. Pathology reported liver cell adenoma which showed 7.8cm size.

Conclusions : A totally laparoscopic ALPPS procedure is feasible in selected patients.