Right hemihepatectomy - general and visceral surgery

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  • Laparotomy

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    Laparotomy
     

    Transverse right epigastric incision with careful hemostasis, in the midline carried to the xyphoid process; exploration of the abdominal cavity; after covering the wound edges with moist surgical towels insert the retractor system.

  • Dividing the falciform ligament

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    Dividing the falciform ligament
     

    After ruling out extrahepatic metastasis divide the falciform ligament.

  • Freeing the liver

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    Freeing the liver
     

    Divide the right triangular ligament; free the liver from its adhesions with the diaphragm and expose the hepatocaval confluence.

  • Exposing the inferior vena cava

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    Exposing the inferior vena cava
     
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  • Resecting the gallbladder

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    Resecting the gallbladder
     
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  • Local findings

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    Local findings
     
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  • Exposing the hepatoduodenal ligament

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  • Lymphadenectomy

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    Lymphadenectomy
     
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  • Vessel ligation

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  • Ischemic demarcation

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  • Dividing the hepatic parenchyma

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  • Dividing the right hepatic vein

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  • Dividing the right hepatic duct

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  • Checking for bile leakage, resecting the gallbladder

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  • Checking for hemostasis

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  • Sealing and draining

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  • Reattaching the ligamentum teres hepatis

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  • Closing the abdominal wall

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