Related Experiment Video
Updated: Mar 2, 2026
Techniques of Laparoscopic Right Posterior Sectionectomy: Glissonian Approach and a Parenchymal Transection Technique
Published on: October 6, 2023
Laparoscopic Parenchymal-Sparing Liver Resections Using the Intrahepatic Glissonian Approach
Marcel Autran C Machado1, R Surjan2, T Basseres2
1Department of Surgery, University of São Paulo, São Paulo, Brazil. dr@drmarcel.com.br.
Background:
One of the main criticisms of laparoscopic liver resection is that it is difficult, or not possible, to perform liver-sparing resections. Our aim was to present short videos where the intrahepatic Glissonian approach was used to perform anatomical liver segmental resections, instead of a larger operation, to avoid unnecessary sacrifice of the liver parenchyma.
Methods:
We selected six types of anatomical liver resections to exemplify the use of the intrahepatic Glissonian approach to perform segment-oriented liver resections. These types of hepatectomies were used as an alternative to right or left hepatectomy, or as an alternative to extended liver resections.
Results:
The intrahepatic Glissonian approach was feasible in all cases. The use of anatomical landmarks previously described was essential to reach and control the Glissonian pedicles. Among the liver-sparing resections, we were able to perform right anterior (S5 + S8) and posterior (S6 + S7) sectionectomies, resection of segments 2, 3, and 4, and mesohepatectomy (S4 + S5 + S8). No patient presented postoperative liver failure.
Conclusions:
Laparoscopic liver-sparing resections are feasible and may be a good alternative to hemihepatectomies or extended liver resections. The use of the intrahepatic Glissonian approach can be useful.
