Although laparoscopic liver resection has been widely adopted, laparoscopic right hepatectomy remains a challenging procedure. This video shows the relevant technical maneuvers in each step of a total laparoscopic right hepatectomy.
Patients and Methods
A 47-year-old man was admitted for evaluation of an incidental hepatic mass noted on a health screening test. Two months ago, transarterical chemoembolization was performed for a 3.5-cm hepatocellular carcinoma (HCC), which was located in S7–8; a follow-up abdominal computed tomography (CT) revealed incomplete necrosis of the HCC. The laboratory studies were positive for hepatitis B viral markers and a normal level of alpha-fetoprotein level. The preoperative liver function was Child-Pugh class A. A laparoscopic right hemihepatectomy was performed for this lesion. An anatomic resection of the right liver was possible with selective control of a Glissonian pedicle to the right liver.
The operating time was 305 min. The estimated intraoperative blood loss was approximately 300 ml; an intraoperative transfusion was not necessary. The postoperative pathology confirmed a 3.5 × 2.8 × 2.7 cm HCC with safe margins. The patient was discharged on the 9th postoperative day without any postoperative complications.
A laparoscopic right hepatectomy is feasible for patients with HCC, although the operative technique is still demanding.
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Han, H., Yoon, Y., Cho, J.Y. et al. Laparoscopic Right Hemihepatectomy for Hepatocellular Carcinoma. Ann Surg Oncol 17, 2090–2091 (2010). https://doi.org/10.1245/s10434-010-1066-4
- Inferior Vena Cava
- Hepatic Vein
- Laparoscopic Liver Resection
- Ultrasonic Shear
- Left Lateral Sectionectomy