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Download File: https://pie.med.utoronto.ca/tvasurg/TVASurg_content/assets/masterFolders/PL_segment4a8Resect/video/SD/video.mp4?_=1Segment IVa/VIII liver resection
for Hepatocellular Carcinoma (HCC)
00:17 SURGICAL PLANNING
03:45 EXPOSURE & MOBILIZATION
04:46 PARENCHYMAL TRANSECTION
08:18 SPECIMEN REMOVAL & CLOSING
Case description
- The patient was a 66-year-old male with a history of hepatitis B. He had a hepatocelluar carcinoma on segment 4a/8 measured about 4cm in diameter. An anatomical resection was recommended.
- The optimal surgical resection for parenchymal sparing with adequate margins was an anatomical resection of segments 4a and 8, while portions of segments 4b and 5 maybe included.
- Surface anatomy guides was used to mark three separate transection planes to ensure negative margins and avoid injuries to major vessels.
- Segment 4a/8 pedicles and hepatic veins and branches to the middle hepatic veins were divided during parechymal transection.
- Because the tumour is centred over the middle hepatic vevin (MHV), the MHV will be sacrified once parenchymal transection is completed.
MRI scans
①
Segment 8 hepatic vein and tumour
②
Middle hepatic vein is centered over the tumour
③
Segment 4 hepatic vein and tumour
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3D Model