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Pure laparoscopic left lateral graft procurement with removing segment 3 employing Glissonean approach, indocyanine green fluorescence imaging and in situ splitting for a small infant


 Department of Surgery, Iwate Medical University, Yahaba, Japan

Correspondence Address:
Akira Umemura,
Department of Surgery, Iwate Medical University, 2-1-1 Idaidori, Yahaba, 028-3695
Japan
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jmas.jmas_290_21

We report on a pure laparoscopic left lateral graft procurement with removing segment 3 that employs the Glissonean approach, indocyanine green (ICG) fluorescence imaging and in situ splitting. We first mobilised the liver and confirmed the root of the left hepatic vein (LHV). We then encircled the left Glissonean pedicle, and the segment 3 Glissonean pedicle (G3) was also individually encircled. We performed parenchymal transection of the left lateral segmentectomy using Pringle's manoeuvre. We clipped G3 and confirmed the demarcation line using ICG fluorescence imaging. The inflow in the S2 area was confirmed via intraoperative sonography, and we split segment 3 (S3) from the left lateral sector graft in situ. The left hepatic artery, left portal vein and left hepatic duct were also encircled and divided. The LHV was transected using a linear stapler, and the S2 monosegment liver graft and removed S3 were procured. Our technique reasonably prevents graft-related complications.


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    -  Umemura A
    -  Nitta H
    -  Takahara T
    -  Hasegawa Y
    -  Katagiri H
    -  Kanno S
    -  Takeda D
    -  Sasaki A
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2004 Journal of Minimal Access Surgery
Published by Wolters Kluwer - Medknow
Online since 15th August '04