Evolution of Techniques in Laparoscopic Right Hepatectomy: Towards a Vein-Guided, Glissonean-Based Standard
摘要
As minimally invasive liver surgery has matured, techniques have evolved toward caudal, vein-guided, and parenchyma-sparing strategies that better leverage the laparoscopic view and improve operative control.
This technical report describes the progressive evolution of our laparoscopic right hepatectomy approach.
These modifications shifted the operation from an “open-translated” procedure to a more distinctly minimally invasive strategy. Left semidecubitus positioning improved exposure of the hepatocaval junction, whereas post-transection mobilization minimized traction on the hepatic veins and retrohepatic vena cava.
The evolution of laparoscopic right hepatectomy reflects adaptation to the strengths of minimally invasive liver surgery. In selected patients, a caudal, vein-guided approach with delayed mobilization and individualized hilar control may improve anatomic orientation, definition of the transection plane, and technical precision.