METHOD anatomical resection of IV, V and VIII SEGMENTS OF THE LIVER

摘要

Method anatomical resection IV, V, VIII liver segments includes laparotomy, the liver mobilization, cholecystectomy, selection and taking at the turnstile right hepatic vein, selection and crossing Glisson legs, which cut through the cystic plate visualized base right paramedian sectoral Glisson legs layered tissue transition line peritoneum hepatoduodenal ligament liver capsule, forming an upper opening at the base of right leg shared by its upper edge, a lower opening formed lateral ravoy spigelevoy vein, exposing thereby the portal plate on both sides of the right common leg precisely dissector peeled liver parenchyma from the back surface of the portal plate right lobar legs and operate circular bypassing the latter, the reverse movement of the dissector is carried around the right common leg two tapes, the bottom end one of them behind hepatoduodenal ligament translate to the left, thereby forming a tourniquet around the left common leg delaminated tissue transition lines peritoneum gepatoduoden flax bundles into the capsule of the liver at the site of the ramification right sector legs, then expose the portal plate at the bifurcation sectoral legs precisely dissector peeled liver parenchyma on its Glisson sheath produce circular circumvention right paramedian sectoral legs and reverse movement of the dissector is carried around the braid, dissect peritoneum sheet between the lower edge of the left hepatic vein at its mouth and arantsievym duct, dissector produce precision-sequence detachment parenchyma Pec