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Updated: Jan 26, 2026
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Modified Laparoscopic Anatomic Hepatectomy: Two-Surgeon Technique Combined with the Simple Extracorporeal Pringle Maneuver
Published on: June 16, 2023
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Right anatomical hepatectomy: pioneers, evolution, and the future
Atsushi Nanashima1, Shun-Ichi Ariizumi2, Masakazu Yamamoto2
1Division of Hepato-Biliary-Pancreatic Surgery, Department of Surgery, University of Miyazaki Faculty of Medicine, Kihara 5200, Kiyotake, Miyazaki, 889-1692, Japan. a_nanashima@med.miyazaki-u.ac.jp.
Surgery Today
|April 15, 2019
Summary
Right anatomical hepatectomy (RAH) has evolved over 70 years, pioneered by Honjo and Lortat-Jacob. Future RAH aims to enhance patient safety and curability for liver malignancies.
Area of Science:
- Hepatobiliary Surgery
- Surgical Oncology
- Anatomical Liver Resection
Background:
- Right anatomical hepatectomy (RAH) is a complex procedure for liver malignancies.
- Its development has been documented in global literature since the 1940s.
Purpose of the Study:
- To trace the historical development of RAH.
- To identify key figures and advancements in RAH techniques and concepts.
- To project future directions in RAH.
Main Methods:
- Comprehensive review of historical literature (Eastern and Western) on RAH.
- Analysis of changes in anatomical concepts, vascular control, surgical approaches, and pre-operative management.
- Inclusion of expert commentary and translation of non-English sources.
Main Results:
- Pioneering RAH cases reported by Honjo (1949) and Lortat-Jacob (1951).
- Evolution of vascular inflow control (intrafascial, extrafascial, transfissual).
- Development of anatomical transection borders and alternative anterior approaches, including laparoscopic techniques.
Conclusions:
- RAH has been an established treatment for liver malignancies for seven decades.
- Ongoing advancements focus on optimizing safety and curability through new concepts, approaches, and techniques.
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