Abstract:

The patient with hepatocellular carcinoma (CNLC2019 stage Ia) underwent laparoscopic anatomic segmentectomy for S4. Under laparoscopy, five holes and artificial pneumoperitoneum with CO₂ established. After the ligamentum teres and falciform ligament were dissected, the liver parenchyma was splitted along the left side of the ligamentum teres to expose the terminal branches of the umbilical fissure vein. Then the umbilical fissure vein was exposed to the root of the middle hepatic vein with Laennec approach. More than 10 pedicles of S4 were separated and disconnected through Laennec approach. The middle hepatic vein was fully expose from the cephalic side by dorsal approach combined with Laennec approach. Finally, S4 was resected completely along the ischemic line of the liver surface and the middle hepatic vein. The median operating hole was extended to remove the specimen.

Key words: Hepatocelluar carcinoma, Anatomical liver resection, Laennec approach, Dorsal approach