Yaojun Zhang, Yangxun Pan, Jinbin Chen, Li Xu, Dandan Hu. Sun Yat-Sen University Cancer Center
A 39-year-old female patient presented with a 55 x 40 mm liver mass in the middle lobe. She was clinically diagnosed to have primary liver cancer, with serum alpha fetoprotein (AFP) level 212.8 ng/ml. Surgical procedure are listed as below: 1) Dissect the ligamentum teres hepatis and falciform ligament, resect the gull bladder, explore of the size and location of the intrahepatic lesion with intraoperative laparoscopic ultrasound, apply hepatic portal blockage with Pringle’s Maneuver when necessary. 2) The left margin is along the right side of the falciform ligament, dissect the liver parenchyma with ultrasound knife to reach the secondary hepatic portal and anterior of the inferior vena cava. Special notice should be paid when dealing with the hepatic pedicle of segment IVa and IVb. 3) The inferior margin is along the hilar plate, dissect the liver parenchyma from left to right, towards the right anterior hepatic pedicle. 4) The right margin is marked by the right hepatic vein and the demarcation line of segment V and VI. The right margin was achieved through dissecting the liver parenchyma until the right anterior hepatic pedicle and the secondary liver portal. 5) Endo-GIA stapler was used to ligate the right anterior hepatic pedicle and the middle hepatic vein, and specimen was then removed. 6) The bleeding of the cutting surface was controlled by bipolar coagulation forceps, and right anterior hepatic pedicle was stitched with Prolene suture. A drainage tube was placed in the right subphrenic space, and specimen was taken out from the abdomen. Surgical duration was 128 minutes with 300 ml blood loss. The patients recovered well, she was dismissed from hospital 8 days postoperatively.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 92239
Program Number: V236
Presentation Session: Video Loop Day 2
Presentation Type: VideoLoop
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