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Gross Anatomy of the Liver

Gross Anatomy of the Liver

The liver, the largest gland within the human body, is a firm and reddish-brown organ. This wedge-shaped structure weighs approximately 1.5 kg and occupies a significant portion of the right hypochondriac and epigastric regions. It extends more to the right of the body's midline than to the left.
Located under the diaphragm, the liver is almost entirely ensconced within the rib cage, providing it with substantial protection. Except for the superior most bare area, the liver's surface is covered...

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Modified Laparoscopic Anatomic Hepatectomy: Two-Surgeon Technique Combined with the Simple Extracorporeal Pringle Maneuver

Modified Laparoscopic Anatomic Hepatectomy: Two-Surgeon Technique Combined with the Simple Extracorporeal Pringle Maneuver

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The liver hanging manoeuvre.

Guido Liddo¹, Emmanuel Buc, Ganesh Nagarajan

¹Department of Hepato-Pancreato-Biliary Surgery and Transplantation, Beaujon Hospital-University Denis Diderot Paris, Assistance Publique-Hôpitaux de Paris, Clichy, France.

HPB : the Official Journal of the International Hepato Pancreato Biliary Association

|September 1, 2009

Summary

The liver hanging manoeuvre (LHM) enhances the anterior approach (AA) for liver resections, improving patient outcomes and reducing complications. This safe and feasible technique is recommended for most anatomical hepatectomies.

Keywords:

anatomic resection anterior approach caval avascular plane hanging manoeuvre hepatocellular carcinoma liver

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Area of Science:

Hepatobiliary Surgery
Surgical Innovation
Oncology

Background:

The anterior approach (AA) is a significant advancement in major hepatic resections.
Classical approaches present limitations in hemorrhage control, tumor handling, and hemodynamic stability.

Purpose of the Study:

To evaluate the role of the liver hanging manoeuvre (LHM) in facilitating the anterior approach (AA).
To highlight the benefits and safety of LHM in anatomical liver resections.

Main Methods:

The liver hanging manoeuvre (LHM) is described as a technique to aid the anterior approach (AA).
Variants of LHM have been developed for various anatomical liver resections.

Main Results:

AA offers advantages including reduced hemorrhage, less tumor manipulation, improved hemodynamic stability, and better survival for hepatocellular carcinoma (HCC) patients.
LHM simplifies AA by guiding anatomical transection and elevating the parenchyma.
LHM demonstrates high feasibility (>90%) and safety with minor complications (<7%) in experienced centers.

Conclusions:

LHM is a safe and feasible technique that enhances the anterior approach for liver resections.
LHM should be considered for most anatomical hepatectomies due to its demonstrated advantages.