Right hemihepatectomy (to posterior sectionectomy) [case 13]

OR Footage

Summary of surgeons' findings and slowing down moments:

Procedure-specific moments

  • Laparotomy for extrahepatic disease
  • Mobilization of right liver
  • Intraoperative ultrasound
  • Check for liver disease
  • Dissection of inflow vessels
  • Dissection of PV bifurcation
  • Dissection of outflow vessels
  • Avoid common bile duct
  • Right hepatic vein dissection
  • Hanging maneuvre
  • Pringle maneuvre

Patient-specific moments

  • Review tumor locations on previous imaging
  • Proximity of tumors to vascular structures
  • Intrahepatic ductal dilatation in Sg 7
  • Sg 7 branch at right portal vein bifurcation
  • Divide bile duct in liver
  • Possible posterior sectorectomy, local resection
  • Biliary guide or contrast
  • Inspect lymph nodes at hepatoduodenal ligament

Watch the following videos from the operation to see some of the key moments in the case.

Mobilization of right liver
Discussion of procedure options [Right posterior sectionectomy]
Portal dissection inflow vessels: Right hepatic artery, Portal vein to Sg 6-7
Unplanned moments: Verifying transection plane
Transection of biliary/hilar plate structures
Parenchymal transection and Sg6-7 hepatic duct
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