Related Experiment Video
Updated: Feb 23, 2026

Laparoscopic Anatomic S7+S8d Resection Preserving Inferior Right Hepatic Vein and S6 with Right Hepatic Vein Transection
Published on: December 30, 2025
Modified hanging manoeuvre facilitates inferior vena cava resection and reconstruction during extended right
Shamir O Cawich1, Dexter A W Thomas1, Vindra Ragoonanan1
1Department of Clinical Surgical Sciences, University of the West Indies, St. Augustine, The Republic of Trinidad and Tobago.
Abstract:
Liver resections are safe when performed by specialized hepatobiliary teams. However, complex liver resections are accompanied by significant perioperative risk and they may require modifications of the conventional surgical techniques. We herein report the case of a 54-year-old male patient who underwent an extended right liver resection with en bloc resection and reconstruction of the inferior vena cava. For this complex resection, a modification of the standard operative technique was required. A modified hanging manoeuvre was performed using two 19Fr nasogastric tubes outside the traditional avascular plane to facilitate resection. This modification of the hanging manoeuvre was proven to be feasible and safe, and it is recommended for inclusion in the armamentarium of hepatobiliary surgeons when complex resections are required.

