Laparoscopic liver resection

March 25, 2009 § 1 Comment

An endoscopic ultrasound probe is used to map the blood vessels.

An endoscopic ultrasound probe is used to map the blood vessels.

A video I’ve made of a laparoscopic liver resection was published on www.oncolex.no last week.

This is a resection of segment 2 and 3 of the liver, located to the left of the falciform ligament. The tumor is in segment 2, close to where the left hepatic vein enters the inferior vena cava.

The liver is mobilized by cutting the falciform ligament and the left lobe’s connection to the diaphragm. The portal vein and hepatic artery are identified and the left branch of the portal vein is exposed.

The liver capsule is cut open before an endoscopic ultrasound probe is used to locate the tumor and map the blood vessels around it. The probe is removed and the ligament is dissected up to the inferior vena cava. The left lobe is lifted to identify the left hepatic vein and its entrance into the inferior vena cava.

The capsule is cut all the way up to the left hepatic vein and the parenchyma is then dissected using ultrasound instruments. The left hepatic artery is clipped and cut before the left branch of the portal vein is cut using an EndoGIA surgical stapler. Finally the left hepatic vein and remaining liver tissue is cut with an EndoGIA.

The specimen is put in a plastic bag and removed via a widened incision in the umbilicus.

Watch the laparoscopic liver resection video

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