Annals of Surgical Oncology

, Volume 24, Issue 6, pp 1606–1609 | Cite as

Three-Dimensional Laparoscopic Anatomical Segment 8 Liver Resection with Glissonian Approach

  • Jae Yool Jang
  • Ho-Seong HanEmail author
  • Yoo Seok Yoon
  • Jai Young Cho
  • YoungRok Choi
  • Woohyung Lee
  • Hong Kyung Shin
  • Han Lim Choi
Hepatobiliary Tumors



Anatomical liver resection has been reported to have oncologic benefit over nonanatomical resection in surgery for hepatocellular carcinoma (HCC). Basic concept of anatomical resection is preventing tumor spread through the portal or venous flow. Few cases have been reported for laparoscopic anatomical segment 8 resection because of its technical difficulties. This video shows operative techniques for laparoscopic anatomical resection of segment 8, exposing middle and right hepatic vein and inferior vena cava using three-dimensional video.


A 61-year-old male was diagnosed to be a hepatitis B virus carrier 6 years ago. A 6.6-cm-sized HCC lesion was detected at segment 8 by computed tomography scan. We have used a high-definition, three-dimensional laparoscope with a deflectable tip (Olympus Medical Systems Corp., Japan), a trocar inserted in the right seventh intercostal space to obtain the optimal field of view on the superior-posterior portion of the liver. Using the Glissonian pedicle approach, we isolated and clamped the branch to the segment 8 to confirm the anatomical border of the segment 8. Segmentectomy was completed exposing the middle and right hepatic vein and inferior vena cava.


Operation took 420 min. Estimated blood loss was 600 mL, and no red blood cell was transfused. Final pathology was an HCC with 0.3-cm safety margin. The patient discharged on the sixth day after operation with normal liver function test results. There was no operation-related complication from the operation day to the first outpatient visit day.


Laparoscopic anatomical resection of segment 8 is feasible.


Inferior Vena Cava Laparoscopic Liver Resection Middle Hepatic Vein Right Hepatic Vein Nonanatomical Resection 
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  1. 1.
    Makuuchi M, Imamura H, Sugawara Y, Takayama T. Progress in surgical treatment of hepatocellular carcinoma. Oncology. 2002;62(Suppl 1):74–81.CrossRefPubMedGoogle Scholar
  2. 2.
    Matsumoto T, Kubota K, Aoki T, Iso Y, Kato M, Shimoda M. Clinical impact of anatomical liver resection for hepatocellular carcinoma with pathologically proven portal vein invasion. World J Surg. 2016;40(2):402–11.CrossRefPubMedGoogle Scholar
  3. 3.
    Hasegawa K, Kokudo N, Imamura H, et al. Prognostic impact of anatomic resection for hepatocellular carcinoma. Ann Surg. 2005;242(2):252–9.CrossRefPubMedPubMedCentralGoogle Scholar
  4. 4.
    Munene G, Vauthey JN, Dixon E. Summary of the 2010 AHPBA/SSO/SSAT consensus Conference on HCC. Int J Hepatol. 2011;2011:565060.Google Scholar
  5. 5.
    Lee W, Han HS, Yoon YS, Cho JY, Choi Y, Shin HK. Role of intercostal trocars on laparoscopic liver resection for tumors in segments 7 and 8. J Hepatobil Pancreat Sci. 2014;21(8):E65–8.CrossRefGoogle Scholar
  6. 6.
    Cheung TT, Poon RT, Yuen WK, et al. Long-term survival analysis of pure laparoscopic versus open hepatectomy for hepatocellular carcinoma in patients with cirrhosis: a single-center experience. Ann Surg. 2013;257(3):506–11.CrossRefPubMedGoogle Scholar
  7. 7.
    Han HS, Shehta A, Ahn S, Yoon YS, Cho JY, Choi Y. Laparoscopic versus open liver resection for hepatocellular carcinoma: case-matched study with propensity score matching. J Hepatol. 2015;63(3):643–50.CrossRefPubMedGoogle Scholar
  8. 8.
    Ishizawa T, Gumbs AA, Kokudo N, Gayet B. Laparoscopic segmentectomy of the liver: from segment I to VIII. Ann Surg. 2012;256(6):959–64.CrossRefPubMedGoogle Scholar
  9. 9.
    Buell JF, Cherqui D, Geller DA, et al. The international position on laparoscopic liver surgery: the Louisville Statement, 2008. Ann Surg. 2009;250(5):825–30.CrossRefPubMedGoogle Scholar
  10. 10.
    Vibert E, Perniceni T, Levard H, Denet C, Shahri NK, Gayet B. Laparoscopic liver resection. Br J Surg. 2006;93(1):67–72.CrossRefPubMedGoogle Scholar
  11. 11.
    Ahn KS, Han HS, Yoon YS, Cho JY, Kim JH. Laparoscopic anatomical S5 segmentectomy by the Glissonian approach. J Laparoendosc Adv Surg Tech A. 2011;21(4):345–8.CrossRefPubMedGoogle Scholar

Copyright information

© Society of Surgical Oncology 2017

Authors and Affiliations

  • Jae Yool Jang
    • 1
  • Ho-Seong Han
    • 2
    Email author
  • Yoo Seok Yoon
    • 2
  • Jai Young Cho
    • 2
  • YoungRok Choi
    • 2
  • Woohyung Lee
    • 3
  • Hong Kyung Shin
    • 4
  • Han Lim Choi
    • 5
  1. 1.Department of SurgeryGyeongsang National University HospitalJinjuKorea
  2. 2.Department of Surgery, Seoul National University Bundang HospitalSeoul National University College of MedicineSeoulKorea
  3. 3.Department of SurgeryGyeongsang National University School of MedicineJinjuKorea
  4. 4.Department of SurgeryThe Armed Forces Medical CommandSeongnam-siKorea
  5. 5.Department of SurgeryChungbuk National University HospitalCheongjuKorea

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