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Updated: Jul 6, 2026
Laparoscopic Anatomical Right Hemihepatectomy via the In Situ Anterior Approach
Published on: August 8, 2025
Liver hanging maneuver for right hemiliver in situ donation--anatomical considerations
B Trotovsek1, E M Gadzijev, D Ravnik
1Department of Abdominal Surgery, University Medical Centre, Ljubljana, Slovenia. blaz.trotovsek@kclj.si
Background:
An anatomical study was carried out to evaluate the safety of the liver hanging maneuver for the right hemiliver in living donor and in situ splitting transplantation. During this procedure a 4-6 cm blind dissection is performed between the inferior vena cava and the liver. Short subhepatic veins entering the inferior vena cava from segments 1 and 9 could be torn with consequent hemorrhage.
Materials And Methods:
One hundred corrosive casts of livers were evaluated to establish the position and diameter of short subhepatic veins and the inferior right hepatic vein.
Results:
The average distance from the right border of the inferior vena cava to the opening of segment 1 veins was 16.7+/-3.4 mm and to the entrance of segment 9 veins was 5.0+/-0.5 mm. The width of the narrowest point on the route of blind dissection was determined, with the average value being 8.7+/-2.3 mm (range 2-15 mm).
Discussion:
The results show that the liver hanging maneuver is a safe procedure. A proposed route of dissection minimizes the risk of disrupting short subhepatic veins (7%).
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