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Download File: https://pie.med.utoronto.ca/tvasurg/TVASurg_content/assets/masterFolders/PL_laprightpost/video/HD/video.mp4?_=1Laparoscopic right posterior sectionectomy
With ultrasonic dissection and Pringle maneuver
00:17 Surgical Plan
01:58 Patient position and port placement
03:18 Mobilization and defining margins
04:30 Pringle maneuver setup
Case Description
- The patient was a 57 year old man with a hepatocellular carcinoma, found in the segment 6/7 liver.
- He has been previously diagnosed with a chronic HBV infection, has liver cirrhosis with a Child score A, and no portal hypertension
- A laparoscopic segment 6/7 sectionectomy was planned, using an ultrasound dissector as well as the Pringle maneuver to occlude portal and hepatic artery inflow.
- The Pringle maneuver is used throughout the transection phase, with a maximum duration of 20 minutes, followed by a 5-minute interval of reperfusion.
- The transection plane deviates slightly lateral in segment 7. This is done to maximize functional liver remnant, due to the degree of cirrhosis.
CT Scans
①
The main segment 6 RHV branch is divided. One of the segment 7 RHV branches will also be divided.
②
Segment 7 pedicle.
③
Segment 6 pedicle.
④
Hepatocellular carcinoma.
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