Laparoscopic right posterior lobectomy
Jingshi Zhou
Abstract
Jingshi Zhou
Abstract
The operation was performed by using left 60°lying position. During the operation, the paravena cava and the anterior space of inferior vena cava were dissected. The first hepatic portal was blocked by using a pre-set blocking band, then the caudate lobe was exposed. The Glisson sheath of the right posterior lobe liver was identified along the Rouviere ditch, therefore suspension and ligation were carried out, then first hepatic portal was released. During the operation, ultrasound was used to locate the tumor and right hepatic vein and to determine whether vessels of right posterior lobe were blocked completely. To dissect the hepatic capsule along the ischemic line, to expose the liver parenchymalayer by layer by using ultrasonic knife. To disconnect the Glisson sheath of right posterior lobe by using closure device, and to locate the right hepatic vein above Glisson sheath of right posterior region. To dissect the left side of the hepatic vein to the second hepatic portal, from bottom to top, to cut off the short hepatic vein and the ligament of the vena cava one by one, to expose the root of the right hepatic vein and to cut off right posterior lobe by using closure devices, which was put into a specimen bag. The specimen was taken out through the transverse incision in the lower abdomen. Key words: Carcinoma, hepatocellular; Laparoscopes; Hepatectomy
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The operation was performed by using left 60°lying position. During the operation, the paravena cava and the anterior space of inferior vena cava were dissected. The first hepatic portal was blocked by using a pre-set blocking band, then the caudate lobe was exposed. The Glisson sheath of the right posterior lobe liver was identified along the Rouviere ditch, therefore suspension and ligation were carried out, then first hepatic portal was released. During the operation, ultrasound was used to locate the tumor and right hepatic vein and to determine whether vessels of right posterior lobe were blocked completely. To dissect the hepatic capsule along the ischemic line, to expose the liver parenchymalayer by layer by using ultrasonic knife. To disconnect the Glisson sheath of right posterior lobe by using closure device, and to locate the right hepatic vein above Glisson sheath of right posterior region. To dissect the left side of the hepatic vein to the second hepatic portal, from bottom to top, to cut off the short hepatic vein and the ligament of the vena cava one by one, to expose the root of the right hepatic vein and to cut off right posterior lobe by using closure devices, which was put into a specimen bag. The specimen was taken out through the transverse incision in the lower abdomen. Key words: Carcinoma, hepatocellular; Laparoscopes; Hepatectomy
Key concepts: Medicine, Falciform ligament, Anatomy, Right gastric vein, Lobe, Inferior vena cava, Vein, Hepatectomy