OR / Prep · Hepatobiliary Surgery · open
You’re scrubbing into
Liver resection (segmentectomy)
Why are we operating?
Removal of anatomical liver segments along Couinaud's planes: cancer surgery built on the fact that the liver is eight independent territories, each with its own inflow, outflow and duct.
Indication: Colorectal liver metastases, hepatocellular carcinoma in a non-cirrhotic or well-compensated liver, and symptomatic benign lesions.
The operation in 4 steps
01Assessment and ultrasound
02Inflow control
03Parenchymal transection
04The cut surface and drains
Danger zones
Common bile duct
The structure every biliary operation is designed not to injure; misidentification is the field's defining catastrophe.
Right hepatic artery
Crosses the triangle aberrantly in about one in seven patients, hugging the cystic duct.
Duct of Luschka
A small subvesical duct in the liver bed; missed, it declares itself as a postoperative bile leak.
Watch it done
Minimally invasive liver resection
A short institutional explainer of how a segment of liver is taken laparoscopically.
Source: Emory Healthcare · Watch on YouTubeLearning curve and techniques of laparoscopic liver resection
A society presentation on technique and how the difficult liver changes the plan.
Source: SAGES · Watch on YouTube
Conceptual teaching for learners preparing to observe and assist under supervision, not operative instructions. Five minutes from now you should know why this operation exists, what its shape is, and which structures it is designed not to injure.