Image-guided laparoscopic anatomic liver resection

Numerous series and guidelines have demonstrated the safety and advantages of laparoscopic liver resection.^1,2 Thorough analysis of preoperative images and intraoperative ultrasound allow for detailed assessment of the intrahepatic anatomy and second- and third-order branches of the liver remnant.³ Therefore, they are a fundamental tool to guide anatomical or parenchyma-sparing resections, especially in cases of difficult-to-locate lesions.⁴ We present the case of a patient with a lesion immediately caudal to the bifurcation of the dorsal and ventral branches of segment VIII and the pedicle of segment V. The video demonstrates the anatomical segmentectomy of segment V. The procedure was uneventful, and the total Pringle maneuver time was 30 min. The patient was discharged on the fourth postoperative day, with no complications. The pathological analysis confirmed the diagnosis of liver metastasis from a colorectal carcinoma that respected surgical resection margins (R0).

All procedures performed in studies with human participants were conducted in accordance with the ethical standards of the institutional and/or national research committees and the Declaration of Helsinki of 1964 and subsequent amendments or comparable ethical standards. Informed consent was obtained from all individual participants involved in the study.