Surgical dissection using tissue planes and anatomical "gateways" around the liver and pancreas

Presented by Dr. Benjamin Loveday
 
 
Chapters
Lecture description

Tissue dissection during surgery requires the surgeon to get into a desired tissue plane in order to delineate structures, minimize bleeding, and avoid visceral and vascular injury.

Navigating through and around anatomical structures could be compared to walking through a building of corridors. When there is a door in the corridor, it must be opened before being able to progress further. Likewise, in order to get to a corridor at a different level, a passageway must exist between the two levels. Each of these transitions, either forward through a door or down to the next level, requires passage through a ‘gateway’. In surgical dissection, anatomical structures form ‘gateways’ that must be divided in order to progress the dissection along a tissue plane, or to expose a structure at a deeper tissue plane.

In HPB surgery, understanding six key anatomical gateways will facilitate surgical dissection during common procedures. Each of these will be illustrated with specific examples from clinical cases.

 
 

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