完全腹腔镜下右半肝切除

切除胆囊后,向左牵拉胆囊管,显露门静脉右支,分离,7号丝线结扎;分离出肝右动脉,结扎切断。显露左右半肝缺血线。游离肝结肠韧带,肝肾韧带,右侧冠状韧带,肝镰状韧带,右半肝充分游离。沿缺血线切开肝脏实质,结扎切断肝中静脉5段支,应用Endo GIA blue reload离断右肝蒂后沿下腔静脉前面结扎切段右侧肝短静脉,继续沿缺血面离断肝组织,结扎切断肝中静脉第8段支,显露肝右静脉,Endo GIA white reload离断。完整切除右肝。装入自制标本袋。取出!

Total Laparoscopic Hepatectomy of lower right hemiliver Surgeon

Remove the cystic duct to the left after cholecystectomy , exposing the right side of the portal vein which was carefully dissected, and vessel was tied off by 7 silk suture.With appearing of ischemic line in the middle of liver, right hepatic artery was cut off after carefully dissected and tied off .Dissociate ligamentahepatocolicum, ligamentahepatorenale, right coronary ligament, ligamentafalciformehepatis and right hemiliver was carefully dissected.Cut the liver along the ischemic line of liver , the middle hepatic vein of 5th segment was cut off after carefully dissected and tied off .Cut off and tied off SHVS along IVC by EndoGIA BLUE reload after cut off hepatic pedicle .Cut off hepatic pedicl and 8th segment of middle hepatic vein was cut off.Expose and cut off the right vein of the liver by EndoGIA BLUE reload , removal of the whole right liver,and put it in the specimen bag , take it out!