Right hemihepatectomy

  1. Laparotomy

    Video
    Laparotomy

    Transverse right epigastric incision with careful hemostasis, in the midline carried to the xyphoid process; exploration of the abdominal cavity; after covering the wound edges with moist surgical towels insert the retractor system.

  2. Dividing the falciform ligament

    Video
    Dividing the falciform ligament

    After ruling out extrahepatic metastasis divide the falciform ligament.

  3. Freeing the liver

    Video
    Freeing the liver

    Divide the right triangular ligament; free the liver from its adhesions with the diaphragm and expose the hepatocaval confluence.

  4. Exposing the inferior vena cava

    Video
    Exposing the inferior vena cava

    Free the liver from caudad as well; expose the posthepatic inferior vena cava and manage the contributing veins there with clips or suture-ligatures. Encircle the right hepatic vein with a vessel loop.

  5. Resecting the gallbladder

    Video
    Resecting the gallbladder

    After exploration of the hepatic hilum dissect the gallbladder in antegrade fashion from its bed and resect.

Local findings

Examine the liver and verify the preoperative findings for vascular anatomy, location and size of t

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