PMC3615917_01
Prechemotherapeutic CT. A middle hepatic vein is performed exclusion of along mass margins (arrow).
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An abdominal CT scan revealed a hepatic tumor occupying segments V to VIII of the right lobe, shifting the middle hepatic vein to the left (Figure 1).
PMC3615917_02
This forceps with a highly-curved and long tip is useful for tunneling through a small incision.
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Under non-direct vision in the dorsal surface of the liver, separation was continued with dissecting forceps (made by Nitta; Iwate medical Univercity) (Figure 2), from the caudate lobe toward the loose space between the right hepatic vein and the trunk of the common hepatic vein (Figure 3).
The forceps passes between the liver and the IVC. (A) This forceps is useful for tunneling through a small incision. (B) The tip of the forceps is appeared from the anterior surface of the IVC in the suprahepatic portion.
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Under non-direct vision in the dorsal surface of the liver, separation was continued with dissecting forceps (made by Nitta; Iwate medical Univercity) (Figure 2), from the caudate lobe toward the loose space between the right hepatic vein and the trunk of the common hepatic vein (Figure 3).
Lifting the liver with a tape, the liver transaction was performed primarily using CUSA.
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The transection was performed using the Cavitron Ultrasonic Surgical Aspirator (CUSA; Integra lifesciences Corporation, Newjersey, United States) and EnSeal (Ethicon Endo-Surgery, Ohio United States) (Figure 4).