Journal of Gastrointestinal Surgery

, Volume 23, Issue 4, pp 825–826 | Cite as

Pure Laparoscopic Right Posterior Sectionectomy Using the Glissonean Approach and a Modified Liver Hanging Maneuver (Video)

  • Ji Hoon KimEmail author
Multimedia Article



Laparoscopic right posterior sectionectomy is technically challenging secondary to poor exposure of the surgical field and difficulty with controlling hemorrhage during deeper parenchymal transection Cho et al., Surgery 158:135–141, 2015; Lee et al., Surgery 160:1219–1226, 2016. We present laparoscopic right posterior sectionectomy using the Glissonean approach and a modified liver hanging maneuver.


A 57-year-old man presented with a single mass in segment 7 of the liver. He was placed in the lithotomy position, and five trocars were used in the upper abdomen. The hepatoduodenal ligament was encircled using an umbilical tape to perform the intermittent Pringle maneuver.

After detachment of the hilar plate, the right posterior Glissonean pedicle was dissected and clamped to confirm ischemic delineation Takasaki, J Hepato-Biliary-Pancreat Surg 5:286–291, 1998. After complete mobilization of the right liver, the hanging tape was placed along the inferior vena cava between the caval ligament and the right hepatic vein. The hanging tape elevates the liver and guides the surgeon to achieve an accurate transection plane

Belghiti et al., J Am Coll Surg 193:109–111, 2001; Kim et al., Surg Endosc 30:3611–3617, 2016; Kim, Choi, J Gastrointest Surg 21:1181–1185, 2017; Kim et al., Langenbecks Arch Surg 403:131–135, 2018 . The transection plane used during a right posterior sectionectomy is horizontal and follows the inferior vena cava. However, with the liver hanging maneuver, the horizontal transection plane becomes vertical.


The operation time was 290 min, the estimated blood loss was 120 mL, and the total Pringle maneuver time was 60 min. Final histopathological diagnosis showed a 1.7-cm-sized hepatocellular carcinoma with the resection margin measuring 1.5 cm. The patient was discharged on postoperative day 7 without any complications.


A Glissonean approach with a modified liver hanging maneuver is feasible and useful for laparoscopic right posterior sectionectomy.


Laparoscopic liver resection Right posterior sectionectomy Glissonean approach Liver hanging maneuver 


Author Contribution

Ji Hoon Kim was involved with study conception and design, acquisition of data, analysis and interpretation of data, drafting of manuscript, and critical revision.

Compliance with Ethical Standards

Conflict of Interest

The author declares that there is no competing interests.

Supplementary material

11605_2018_4066_MOESM1_ESM.wmv (328.2 mb)
ESM 1 (WMV 336054 kb)


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Copyright information

© The Society for Surgery of the Alimentary Tract 2018

Authors and Affiliations

  1. 1.Department of Surgery, College of MedicineEulji UniversityDaejeonRepublic of Korea
  2. 2.Department of SurgeryEulji University HospitalDaejeonRepublic of Korea

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