Bona Fide Intersegmental Plane Hepatectomy Along the Glissonean Branches (BIPHG)

This review traces the author's personal journey over three decades in the evolution of liver resection techniques, culminating in the proposal of the Bona Fide Intersegmental Plane Hepatectomy Along Glissonean Branches (BIPHG). Beginning with pioneering experiences in laparoscopic and robotic liver surgeries, the author highlights key anatomical insights-particularly Laennec's capsule and intersegmental planes-that have advanced surgical precision. Transitioning from laparoscopy-assisted to pure laparoscopic donor hepatectomy illustrated the importance of safety, visualization, and anatomy-guided dissection. Inspired by innovations in intraoperative imaging and microanatomy, the author introduces BIPHG-an innovative tension-based technique utilizing indocyanine green (ICG) fluorescence to define natural intersegmental boundaries along Glissonean branches. This method emphasizes real-time visualization, enabling accurate, minimally invasive, and function-preserving liver resections. The review underscores the significance of standardizing definitions and assessment tools, such as the difficulty score, to facilitate broader adoption. Looking forward, ongoing technological and anatomical advances are expected to further refine these approaches, positioning BIPHG as a promising, safe, and precise strategy in minimally invasive liver surgery. This personal narrative aims to contribute to the continued evolution of anatomy-based, minimally invasive hepatic resection techniques.