Comparative surgical resection of the ligamentum teres hepatis in a cadaveric model and a patient with ovarian cancer

İlker Selçuk,Zehra Öztürk Başarır,Bertan Akar,Eray Çalışkan,Nurian Ohri,Tayfun Güngör

doi:10.4274/jtgga.galenos.2018.2018.0135

Abstract

Resection of all tumor implants with the aim of maximal cytoreduction is the main predictor of overall survival in ovarian carcinoma. However, there are high risk sites of tumor recurrence, and the perihepatic region, especially the point where the ligamentum teres hepatis enters the liver parenchyma under the hepatic bridge (pont hepatique), is one of them. This video demonstrates the resection of the ligamentum teres hepatis both in a cadaveric model and in a patient with ovarian cancer.

Highlights

The falciform ligament divides the liver into the right and left lobes on the antero-superior part of portoumbilical fissure where the ligamentum teres hepatis attaches to the visceral surface
The liver parenchyma over this structure varies in thickness, and in some patients the umbilical ligament will be completely visible, which allows broad exposure until its entrance into the liver
Paul Sugarbaker defined this parenchyma surrounding the umbilical ligament as the ‘pont hepatique/hepatic bridge,’ which creates a tunnel [2,3]

Summary

Introduction

Received: 16 October, 2018 Accepted: 21 December, 2018 The falciform ligament divides the liver into the right and left lobes on the antero-superior part of portoumbilical fissure where the ligamentum teres hepatis (umbilical ligament of liver/round ligament of liver) attaches to the visceral surface. Due to the distribution pattern of the portal vein and hepatic veins, the liver is divided into eight functional segments [1].

Results

Conclusion