“Hands” figural teaching method in hepatic anatomy: A surgeon's teaching experience

摘要

We have recently read the article “Totally laparoscopic living donor right hepatectomy in a donor with trifurcation of bile duct” published in your journal by Kuo-Hsin Chen et al. From New Taipei City, Taiwan, in which an application of totally laparoscopic approach for right liver graft harvest in a donor with trifurcation of the bile duct was described. ' The report adds evidence of the feasibility of pure laparo- scopic right donor hepatectomy and describes the neces- sary steps for bile duct division in donors with trifurcation of bile duct. At the same time, the report also emphasized that determining the cut point of bile duct is challenging. Here we would like to describe our clinical and teaching experience on knowledge of liver segment and gallbladder triangle anatomy. Using the image teaching method, the liver anatomy knowledge is skillfully memorized through gesture changes, helping young doctors to quickly grasp the position of each liver segment and bile duct. In the study of the right half of the liver, the left hand is compared to the right liver and the image memory of the upper and lower anterior segments of the right liver carried out. Put the left hand out. Take the fingertips as the side of the head, the wrist as the side of the foot, and the entire left hand as the right side of the liver. Then the vertical left hand is the right side of the liver when the patient is standing. Take the plane of the metacarpophalangeal joint as the section plane perpendicular to the vertical direction of the left hand. Take the plane of the vertical direction of the middle finger of the left hand as the longitudinal section, dividing the left hand into four parts. The right anterior lower part nearest to us is divided into a starting point, going coun- terclockwise, passing through each part exactly as the four parts of the right hemisphere, namely V, VI, VII and VIII.7 As for the study of left liver, the left hand is stretched out like a knife, with the palm perpendicular to the forearm. At this time, the left hand is regarded as the left liver when the patient is standing.