Principles for the determination of surgical plane in laparoscopic anatomic hepatectomy

Abstract

Accurate determination of the surgical plane is a technical difficulty in laparoscopic anatomic hepatectomy. Compared with open surgery, laparoscopic hepatectomy has its own particularity in determining the surgical plane of anatomical hepatectomy due to the lack of sense of touch and the limited operating space. In this paper, some common methods for determining the surgical plane of laparoscopic anatomical hepatectomy were summarized. The mainly methods include: (1)according to the anatomical landmarks on the surface of the liver; (2)guided by the hepatic vein; (3) the selective portal pedicle clamping of the target liver segment; (4) target liver segment portal vein puncture staining. Each of these methods has advantages and disadvantages, and is suitable for different hepatic segment resections. In clinical practice, it should be applied comprehensively under actual situation. Key words: Laparoscopes; Anatomical hepatectomy; Surgical plane