Right hemihepatectomy

Laparotomy via upper abdominal right-angle incision with meticulous hemostasis; transverse in the right upper abdomen, median cranially to the xiphoid; Exploration of the abdomen, folding back of the wound edges and insertion of the retraction device.

After exclusion of extrahepatic metastases, transection of the falciform ligament of the liver.

Division of the right triangular ligament; Mobilization of the liver from the adhesions to the diaphragm with exposure of the venous star

Mobilization of the liver also from caudal; the retrohepatic inferior vena cava is prepared and the veins draining into it are secured by clips or ligations; Looping of the right hepatic vein.

After exploration of the hepatic hilum, the anterograde mobilization of the gallbladder is performed.

Examination of the liver and verification of the preoperative findings regarding vascular anatomy, tumor localization and size; exclusion of additional tumors through inspection, palpation and intraoperative sonography.

Dissection of the ligament with longitudinal splitting of the peritoneum. Exposure of the common hepatic artery with transection and ligation of the right gastric artery.

The common hepatic artery is followed to the upper border of the pancreas and dissected free. The lymphatic stations located here are resected.
The common bile duct is now looped and dissected free, and overall, the entire lymphatic tissue of the hepatoduodenal ligament is resected.

Clamping and transection of the right hepatic artery. The same is done with the right portal vein branch; Ligation of the right hepatic duct.