ArticleAnnals of surgical oncology2021
Arantius' Ligament Approach to Middle Hepatic Vein in Laparoscopic Extended Medial Segmentectomy (with Video).
Article in Annals of surgical oncology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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7 authors at 1 institution in 1 country.
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Abstract
backgroundUnder laparoscopy-specific caudal and lateral view, Aranitius' ligament could be the landmark for the root of the venous trunks in the left hepatic lobe.1-3 We performed laparoscopic hepatic extended medial segmentectomy including the middle hepatic vein (MHV) using the Arantius' approach.
methodsAn 86-year-old man was referred to our hospital for hepatocellular carcinoma, 4.5 cm in size, located in the medial hepatic segment (Video 1). After pneumoperitoneum and placement of four working ports, the Arantius' ligament was exposed, isolated, and divided. The liver parenchyma underneath the Arantius' ligament was opened to widely expose the root of the MHV, umbilical fissure vein (UFV), and left hepatic vein (LHV). After dividing the Glissonean branches for segment 4 (G4), the parenchymal tissue between MHV and LHV was divided. The trunk of the MHV was fully exposed and was divided using the endo-stapling device. Parenchymal resection was further proceeded along the dorsal side of the MHV, and the planned hepatectomy was completed.
resultsThe operation time was 337 min, and the estimated blood loss was 400 g. His postoperative course was uneventful, and he was discharged on postoperative day 10.
conclusionsThe significance of Arantius' ligament approach is short-cut exposure of the MHV as the anatomical landmark during the initial process of the surgery under laparoscopy-specific caudal and lateral view, and is a reasonable technique in extended medial segmentectomy including the MHV.
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