Related Experiment Video
Updated: Jun 13, 2026
Laparoscopic Anatomical Liver Segment VII Resection with Liver Parenchymal Transection Following a Priority Approach
Published on: May 23, 2025
The intersegmental plane of the liver is not always flat--tricks for anatomical liver resection
Junichi Shindoh1, Yoshihiro Mise, Shoichi Satou
1Hepato-biliary-pancreatic Surgery Division, Department of Surgery, Graduate School of Medicine, University of Tokyo, Tokyo, Japan.
Objective:
To investigate the actual three-dimensional (3D) anatomy of the intersegmental plane of the liver to enable safe and precise anatomic resections of the portal territories.
Summary Of Background Data:
Anatomic resection of the liver requires the precise detection of the intersegmental plane. However, we have sometimes encountered a dissociation between conventional understanding of the anatomy of the intersegmental plane and its actual 3D shape.
Methods:
3D simulations of the livers of 81 healthy donors for living donor liver transplantation were reviewed. Several key angles formed between the plane of each venous trunk and the actual intersegmental plane on 3D simulation images were measured. The relation between these angles and the volume ratio of the liver segments located on both sides of the intersegmental plane were also investigated.
Results:
The dissociation between the plane of the venous trunks and the actual intersegmental plane was remarkable, especially in the subphrenic region of the right lobe. The volume ratio of segment VIII compared with segment VII was correlated with the degree of cranio-lateral protrusion of segment VIII (r=0.35, P=0.001); this finding was attributed to the intricate surface of the right portal scissura. The same tendency was observed in the left portal scissura between the angle and the volume ratio of segment III/II (r=0.23, P=0.049), whereas the main portal scissura exhibited a relatively flat surface compared with the other longitudinal scissurae.
Conclusions:
The intersegmental plane of the liver has an uneven and curved surface, especially in the right and left portal scissurae. The identification and exposure of the landmark vein on the cut surface is an important technique for avoiding disorientation during anatomic liver resection.
Related Concept Videos
01:17Gross Anatomy of the Liver
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...
01:06Body Planes
The sagittal plane is the plane that divides the body or an organ vertically into right and left sides. If this vertical plane runs directly down the middle of the body resulting in equal division, it is called the midsagittal or median...