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Updated: Jul 15, 2026
Laparoscopic Anatomical Liver Segment VII Resection with Liver Parenchymal Transection Following a Priority Approach
Published on: May 23, 2025
Laparoscopic Anatomical Resection of Liver Segment IV Guided by Key Venous Landmarks
Yu Zheng1, Jiayi Wu1, Maolin Yan2
1Department of Hepatobiliary and Pancreatic Surgery, Affiliated Provincial Hospital of Fuzhou University, Fuzhou, Fujian, China.
Background:
Laparoscopic anatomical resection of segment IV remains challenging because of its complex anatomy and lack of reliable intraoperative landmarks [1]. We present a novel technique that uses the umbilical fissure vein (UFV) and middle hepatic vein (MHV) as primary guides to achieve accurate resection boundaries.
Methods:
The procedure consisted of four key steps: (1) left-sided parenchymal transection along the UFV; (2) dissection of the hilar plate from the left transection plane to individually ligate segment IV Glissonian pedicles; (3) indocyanine green fluorescence to demarcate the ischemic boundary; (4) right-sided parenchymal transection guided externally by the ischemic line and internally by the MHV.
Results:
The operation was completed successfully, with no intraoperative complications and an uneventful postoperative recovery.
Conclusions:
Laparoscopic anatomical segment IV resection guided by the UFV and MHV appears safe, feasible, and effective.
