Related Experiment Video
Updated: Mar 28, 2026
Techniques of Laparoscopic Right Posterior Sectionectomy: Glissonian Approach and a Parenchymal Transection Technique
Published on: October 6, 2023
Laparoscopic Posterior Sectionectomy Extended to the Right Hepatic Vein: A Low-Cost, Resource-Efficient Approach
Kaival Gundavda1,2, Sanket Mehta3,4,5
1Department of Gastrointestinal and Hepatobiliary-Pancreatic Surgery, Specialty Surgical Oncology Cancer Hospital, Mumbai, Maharashtra, India.
Background:
Laparoscopic posterior sectionectomy (LPS) is a challenging liver resection procedure often requiring advanced techniques and equipment to ensure precision. This video demonstration highlights a cost-effective, resource-efficient technique for LPS using a single-energy device approach, showcasing safe and precise liver resection while emphasizing meticulous surgical techniques.
Methods:
An 81-year-old male patient presented with a solitary lesion in segment VII of the liver, close to the hepatocaval confluence. Preoperative imaging confirmed a well-circumscribed lesion without vascular invasion. LPS was performed using Ligasure, which served a dual purpose: 'Kelly-clysis' for parenchymal dissection while simultaneously sealing and dividing vascular structures. Key procedural steps included precise anatomical exposure, isolation of major vascular structures, and systematic parenchymal transection under continuous inflow control. Critical aspects of the technique were highlighted, including real-time intraoperative ultrasound guidance for vascular mapping and ensuring minimal blood loss.
Results:
The procedure was completed successfully without intraoperative complications. Operative time was 220 minutes, and estimated blood loss was 60 mL. Cumulative Pringle clamp time was 72 minutes. The postoperative course was uneventful, with the patient discharged on postoperative day 5. Histopathological analysis confirmed R0 resection. The video highlights critical operative strategies to mitigate challenges typically encountered during LPS without cavitron ultrasonic surgical aspirator, demonstrating the feasibility of this technique in resource-limited settings.
Conclusion:
This video highlights the feasibility of laparoscopic posterior sectionectomy using a cost-effective, resource-efficient, single-energy device approach, offering a practical alternative for surgeons. Proper planning, expertise, and use of conventional tools can ensure safe and effective outcomes, even in resource-constrained environments.
