Segment VIII resection

In situ cold perfusion with right and middle hepatic vein reconstruction



02:34  Opening & Mobilization

04:17  Parenchymal transection

05:42  In situ cold perfusion setup

07:16  RHV/MHV reconstruction


Case description
  • A 41 year old female patient was found with metastatic colon cancer. Previous wedge resections has left her with a relatively small left lobe liver.
  • Tumor was found lodged between right and middle hepatic veins, located within the segment VIII liver.
  • The liver will be split from the L/MHV groove to the gallbladder fossa, allowing maximum mobility of the left and right lobes from the vena cava.
  • For additional mobility, the caudate lobe is resected from the left lobe liver.
  • Segment VIII is resected; the right and middle hepatic veins will remain intact in the liver until cold perfusion is set up.
  • With the liver under in situ cold perfusion, the right and middle hepatic veins are divided at their origins and within the liver.
  • The remnant liver is mobilized medially towards the vena cava, and the right/middle hepatic veins are reconstructed to their origins.
MRI scans

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