Pure laparoscopic right hemihepatectomy via anterior approach

In open hepatectomy ear, right hemihepatectomy via anterior approach has been accepted as one of the standard methods in some specialized centers. However, pure laparoscopic right hemihepatectomy by anterior approach is technically demanding [1-5]. Here, we described the technique of pure laparoscopic right hemihepatectomy via anterior approach. We performed three pure laparoscopic right hemihepatectomies via anterior approach between 2013 and 2014. This video illustrated this procedure steps in a 32 years old male with hepatocellular carcinoma. Right hemihepatectomy was performed after hemihepatic vascular inflow occlusion using the lowering of the hilar plate approach [6]. The hepatic parenchyma transection via anterior approach was performed with Ligasure, ultrasound scalpel and bipolar electrocoagulation. The right hepatic vein was divided with an endoscopic vascular stapler. Thereafter, mobilization of the right liver was performed. The operation time was 240 min, and the blood loss was 150 ml. The recovery was uneventful and the patient discharged on postoperative day 8. The pathology was hepatocellular carcinoma with vascular invasion and also satellites foci adjacent to the main tumor. The resection margin was negative. Pure laparoscopic right hemihepatectomy via anterior approach was safe and feasible.