Liver resection for recurrent liver metastasis

Anatomy Perioperative management Technique Complications Evidence Total Video

Content

Access
Adhesiolysis
Liver Hilum Preparation
Mobilization of the Liver
Preparation of the Vena Cava
Resection of the Subcapsular Hematoma
Intraoperative Sonography
Parenchyma Transection
Transection of the Segmental Liver Triad
Sealing of the Resection Surface with HaemoCer PLUS
Drainage; Abdominal Wall Closure

Authors

Date

date of publication: 18.11.2016
date of update: 20.08.2022

Access

Soundsettings
The video clip can be played back with the automatic soundtrack of the subtitles.

In the sidebar registered users can enable and disable the automatic start of the dubbing.

Remark: Since this is a text-to-speech computer voice, it may mispronounce some medical terminology.

Excision of the old upper abdominal right-angle laparotomy following previous atypical metastasis resection in the area of the posterior right liver segments. Preparation down to the peritoneum and opening of the abdomen.
Adhesiolysis

Soundsettings
The video clip can be played back with the automatic soundtrack of the subtitles.

In the sidebar registered users can enable and disable the automatic start of the dubbing.

Remark: Since this is a text-to-speech computer voice, it may mispronounce some medical terminology.

Significant adhesions are encountered in the upper abdomen, making exploration of the abdomen to exclude an extrahepatic tumor and peritoneal carcinomatosis initially only partially possible. Both the right colonic flexure and small bowel loops are adherent to the liver and must be sharply dissected step by step. Then, reposition the wound edges and insert the retractor.
Liver Hilum Preparation

Soundsettings
The video clip can be played back with the automatic soundtrack of the subtitles.

In the sidebar registered users can enable and disable the automatic start of the dubbing.

Remark: Since this is a text-to-speech computer voice, it may mispronounce some medical terminology.

Next, the hepatoduodenal ligament is dissected out of the scar tissue and looped with a Mersilene band. This allows for temporary hilum occlusion (Pringle maneuver) in case of intraoperative bleeding complications.
A lymph node dissection is not performed, as it was already done during the primary procedure, and no enlarged lymph nodes are observed upon inspection and palpation.
Note:
In principle, lymph node dissection of the liver hilum is recommended for colorectal liver metastases, as the incidence, depending on the number and location of the metastases, is reported to be 3-28%.