The Posterior Intrahepatic Approach In Liver Surgery

The objective of The Posterior Intrahepatic Approach in Liver Surgery is to describe techniques, as the more routine application today of split liver, living donor transplantation has continued to teach us more about the anatomy of the liver and its applications. Furthermore, laparoscopic surgery in general has grown space and it is important to show the application of the posterior approach in laparoscopic liver surgery as well.

Aim of this book is to present the main minimally invasive approaches to the Glissonean pedicles. This kind of technique for hepatectomy has been gaining interest in recent years and may represent the ideal method to achieve anatomical liver resections. Currently the most performed procedure for liver surgery is still the classic intrafascial approach in which, after entering the Glissonean sheath, the portal triad elements are singularly dissected and isolated. However, this is a quite challenging technique to pursue in a minimally invasive setting. Nowadays the laparoscopic and robotic approach for liver resections are increasing worldwide and the intra or extra hepatic Glissonean approach, in which the portal triad elements are dissected and isolated “en bloc” without entering the Glissonean sheath, can facilitate the surgical technique. Furthermore this strategy allows better identification of the ischemic area and could decrease blood loss during dissection, as the liver inflow is kept under control. This book includes a step-by-step description of each pedicle isolation and section, with original laparoscopic and robotic pictures and videos. HPB surgeons who are interested in this technique may find these pages, written in cooperation with some of the most prominent worldwide experts, to be highly informative and valuable.

This book comprehensibly describes the clinical details of anatomic hepatic resection using the Glissonean pedicle approach for hepatocellular carcinoma. It includes all aspects of the surgical anatomy of the liver, preoperative management of patients, surgical techniques, and intraoperative key points to prevent postoperative complications. The first three chapters provide a general introduction to the clinical anatomy of the liver, preoperative management of patients with hepatocellular carcinoma, basic techniques for hepatic resection using the Glissonean approach, and the application of dye staining in anatomic hepatic resection. Subsequent chapters present the technical details of anatomical segmentectomy (Couinaud’s classification), sectionectomy and hemi-hepatectomy for hepatocellular carcinoma using the modified suprahilar Glissonean approach. All of these hepatectomies can be performed using simple and easily available surgical instruments. In addition, it discusses precise transection of the deepest hepatic parenchyma guided by methylene blue staining. It is a useful and timely reference for hepatobiliary surgeons, clinical staff, and medical students.

A guide to modern operative techniques in liver surgery. The text gives a detailed description of the operative anatomy and, in particular, the performance of right and left hepatectomy, intrahepatic bypass procedures and the removal of eight segments of the liver, individually or in combination.

Techniques of Liver Surgery is a concise, step-by-step guide to a range of techniques used in liver surgery, from standard approaches to transplantation. Each chapter assesses indications, contraindications, and preoperative planning, before providing a full step-by-step explanation of the procedure. The book also features a detailed description of the “W” technique, a safer technique for performing the hepatic artery anstomosis in living donor liver transplantation. Enhanced by 240 full colour images and illustrations.

Laparoscopic Liver, Pancreas and Biliary Surgery: Textbook and Illustrated Video Atlas is the perfect learning tool for all surgeons managing patients requiring advanced liver, pancreas and biliary surgery minimally invasively. This highly immersive text and video atlas will provide surgeons from trainee to advanced levels of practice, including, general surgeons, hepato-pacreatico-biliary surgeons, transplant surgeons and surgical oncologists, with a step-by-step, multi-media teaching atlas on performing laparoscopic liver surgery, anatomically correct, safely and effectively. The atlas will teach the surgeons to perform anatomic liver resections of each liver segment expertly and logically, and will cover lobectomies, extended resections, advanced laparoscopic pancreas surgery (including Whipple) and other procedures. A special emphasis is placed on reproducibility of excellence in surgical technique. Each video will be supported by outstanding illustrations for each technique and 3D renderings of the relevant anatomy. The educational step-by step high-definition videos teach everything you need to know, including critical aspects like patient positioning, port placement, dissection and much more. Led by the pioneers in laparoscopic liver, pancreas and biliary surgery, Brice Gayet and Claudius Conrad, the textbook-chapters will be authored by world experts and will contain surgical tips and tricks garnered from their unique experiences, to improve care, management of complications, relevant society guidelines and excellence in oncologic care for patients with hepato-pancreato-biliary cancers.

Ultrasound guidance of liver surgery is a very sophisticated approach that permits the performance of otherwise unfeasible operations, discloses the true extent of tumors, increases the indications for hepatectomy, and renders surgery safer. Despite this, it has remained relatively neglected in the literature over the past two decades, during which time much progress has been achieved. This is the first atlas on the subject, and it is comprehensive in scope. The state of the art in the use of ultrasound for resection guidance is carefully documented, and new techniques for exploration of the biliary tract and facilitation of transplant surgery are presented. Further important topics include the role of ultrasound in laparoscopic approaches, the use of contrast agents for diagnosis and staging, and developments in the planning of surgical strategy. The editor is a leading authority whose group has been responsible for a variety of advances in the field. He has brought together other experts whose aim throughout is to provide clear information and guidance on the optimal use of ultrasound when performing liver surgery. This atlas is intended especially for hepatobiliary surgeons but will also be of considerable value for general surgeons.