How I do it : Open right hepatectomy for large HCC proximity to major vessel in cirrhotic liver

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Издатель Apr 15, 2022

This VDO demonstrate how to perform open right hepatectomy for HCC in cirrhotic patient. HCC size about 8 cm and proximity to right anterior portal pedicle and middle hepatic vein. Accurate resection plane is crucial for adequate margin and prevention of MHV injury.

VDO speed is 2x, only parenchymal transection is Timelapse mode(6x speed) to shorten the duration of this VDO. This is nearly uncut for educational propose to demonstration every steps of procedure, including pitfall and how to deal with it.

*some part of VDO was edited because head of assistant/ surgeon obscure camera

Chapters:
0:00 introduction
0:01 Preoperative imaging and surgical planning
0:30 Cholecystectomy (you can skip tis phase)
2:18 Hepatoduodenal ligament dissection
2:51 Selective inflow control
15:13 Temporary inflow clamping
16:00 Check demarcation line with Fluorescence imaging
16:31 Liver mobilization
20:34 Out flow control
21:05 parenchymal transection (6x speed)
29:53 Hilar dissection (for HA, PV, BD division)
37:12 Caudate lobe transection
40:35 RHV division
40:58 Complete hepatectomy
41:20 Suture closing RHV, Machuuchi ligament
42:18 Anatomical landmark after specimen removal