Left Hepatectomy

Technique Description:

Laparoscopic left hepatectomy with partial resection of segment 5.

Procedure Steps:

• 1. Adhesiolysis, laparoscopic exploration with ultrasound.
• 2. Vascular dissection in the porta hepatis.
• 3. Section of the liver inside the S5.
• 4. Section on the left side of the MHV.
• 5. Hemostasis and Tachosil®. No drain.

Learning Points:

• Laparoscopic approach to the hepatic pedicle.
• Management of bleeding.
• Placement of intraoperative ultrasound.

Clinical History:

• 04/2019 Lap' Right Colectomy and Wedge S8.
• ADK pT3N2aM1a L1V1Pn1. B RAF &KRAS WT, NRAS muted, MSS.
• 05/19 to 08/19 FOLFOX + bevacizumab.
• C1-C5, FOLFOX alone C6.
• 08/2019 Lap' Left hepatectomy extended to segment 5 + lymphadenectomy + IO ultrasound.
• 5 mets; 30% to 80% living; lymph nodes <0 ; Margin ok = R0.

Other History:

• Peptic disease with gastric ulcer.
• Smoker 40 PY.