PMC7369466_01
The three-dimensional imaging based on computed tomography showed colorectal liver metastasis, located at the top of segment 7 behind the right hepatic vein.. IVC, inferior vena cava; RHV, right hepatic vein; G7, Glissonean pedicle of segment 7; and V7, venous branch of segment 7.
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Tumor in S7 was located at the top of S7 behind the right hepatic vein, and the relationship between the tumor, the Glissonean branch of S7 (G7) and the venous branch of S7 (V7) was depicted in Fig. 1.
Trocar placement with the subcostal type.
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After the introduction of five trocars at the umbilical portion for the camera and at the subcostal area (Fig. 2), the left semi-decubitus position with the right side elevated approximately 20 degrees was applied.
Intraoperative findings. (A) The Glissonean pedicle of segment 7 (G7) was identified and divided. (B) The right hepatic vein was exposed to identify the venous branch of segment 7 (V7).
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The liver parenchyma was dissected using the Cavitron Ultrasonic Surgical Aspirator (CUSA) and Ultrasonic shears (Harmonic scalpel), and the G7 was divided (Fig. 3A). The RHV was also exposed to transect the V7 (Fig. 3B).