Liver procurement: the counterclockwise technique step-by-step with video.

Abstract

The availability of videos of different procedures is certainly contributing to the diffusion and standardization of surgical procedures around the world. This didactical video article shows step-by-step a "counterclockwise" technique which we have previously described for liver procurement whenever the pancreas is not procured. The technique entails 6 steps: the hepatic pedicle, the pancreatic neck, the superior mesenteric artery (SMA), the celiac trunk, the supraceliac aorta, and the inferior vena cava. This technique follows a "counterclockwise" sequence around the liver. The routine practice with this technique at our unit showed high reproducibility while maintaining the safety of the procedure among different young fellows trained over the years. The limits of this technique are represented by the fact that is reserved to cases without pancreas procurement. The "counterclockwise" technique represents a valid and an easy technique to learn for liver procurement.