Introduction After nearly 25 years of experience, laparoscopic liver resection (LLR) is now recognized as being feasible and safe. However, laparoscopic resections of the posterosuperior segments are more technically demanding. They are associated with higher conversions rates, more intraoperative bleeding, and increased operating time. Appropriate training is required to approach these resections safely. This video demonstrates the technical maneuvers to laparoscopically approach a segment 7 tumor in contact with the right supra hepatic vein. Method The pertinent aspect to perform a segment 7 metastasis resection using minimally invasive techniques is shown. The main steps of this operation include (1) complete release of the right liver from the coronary and triangular ligament, (2) dissection of the retrohepatic vena cava and transection of the hepatocaval ligament, (3) the use of intercostal trocars for direct 4,5 vision of the inferior vena cava and the right suprahepatic vein, (4) the use of intraoperative ultrasound to evaluate the position and limits of vascular structures compared to the lesion, (5) careful transection of the hepatic parenchyma, and (6) dissection of the right hepatic vein to separate it from the lesion. Results The surgery was performed in a 68-year-old male patient. The patient developed synchronous metastases
Journal of Gastrointestinal Surgery – Springer Journals
Published: May 31, 2018
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