Laparoscopic Extended Segmentectomy VII Guided by the Right Hepatic Vein: Precise Surgical Planning with a Three-Dimensional Liver Model

Lun Wang ^1,2,3, Xinci Li ^1,2,3, Zhuojin Song ^1,2,3

¹Department of Hepatobiliary Surgery I, General Surgery Center, Zhujiang Hospital, Southern Medical University, Guangzhou, China.
²Liver Cancer Center, Zhujiang Hospital, Southern Medical University, Guangzhou, China.
³South China Institute of National Engineering Research Center of Innovation and Application of Minimally Invasive Instruments, Guangzhou, China.
⁴The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China.
⁵Department of Hepatobiliary Surgery I, General Surgery Center, Zhujiang Hospital, Southern Medical University, Guangzhou, China. yangjian486@126.com.
⁶Liver Cancer Center, Zhujiang Hospital, Southern Medical University, Guangzhou, China. yangjian486@126.com.
⁷South China Institute of National Engineering Research Center of Innovation and Application of Minimally Invasive Instruments, Guangzhou, China. yangjian486@126.com.
⁸Department of Hepatobiliary Surgery I, General Surgery Center, Zhujiang Hospital, Southern Medical University, Guangzhou, China. taohaisu_dr@126.com.
⁹Liver Cancer Center, Zhujiang Hospital, Southern Medical University, Guangzhou, China. taohaisu_dr@126.com.
¹⁰South China Institute of National Engineering Research Center of Innovation and Application of Minimally Invasive Instruments, Guangzhou, China. taohaisu_dr@126.com.

⁰Department of Hepatobiliary Surgery I, General Surgery Center, Zhujiang Hospital, Southern Medical University, Guangzhou, China.

Annals of Surgical Oncology +

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March 5, 2025

View abstract on PubMed

Summary

Laparoscopic extended segmentectomy VII guided by the right hepatic vein (RHV) is feasible. This technique, using precise surgical planning, offers an effective approach for liver tumor resection.

Area Of Science

Hepatobiliary surgery
Minimally invasive surgery
Surgical oncology

Background

Laparoscopic extended segmentectomy VII is challenging due to unclear anatomical landmarks and difficulty in defining the cutting plane.
Precise surgical planning is crucial for successful execution of this complex procedure.

Purpose Of The Study

To present a technique for laparoscopic extended segmentectomy VII guided by the right hepatic vein (RHV).
To demonstrate the feasibility and effectiveness of RHV-guided segmentectomy VII using precise surgical planning.

Main Methods

A 3D liver model was used for precise surgical planning of a laparoscopic extended segmentectomy VII.
The right hepatic vein (RHV) and segment 6/7 intersegmental vein served as key landmarks for determining the cutting plane.
Intraoperative ultrasound confirmed RHV projection, and liver transection was performed along the RHV trunk.

Main Results

The procedure was completed in 260 minutes with 50 ml blood loss.
Pathology confirmed moderately differentiated hepatocellular carcinoma with a negative surgical margin.
The patient was discharged on postoperative day 9 without complications.

Conclusions

Laparoscopic extended segmentectomy VII guided by the RHV is a feasible and effective surgical approach.
Precise surgical planning, including 3D modeling and identification of vascular landmarks, is essential for successful outcomes.