Post on 26-Jan-2021
Orlando Jorge M. Torres MD, PhD
Full Professor and Chairman
Department of Gastrointestinal Surgery
Hepatopancreatobiliary Unit
Federal University of Maranhão - Brazil
LAPAROSCOPIC LEFT LATERAL
SEGMENTECTOMY
________________________________________________________________________________ Universidade Federal do Maranhão Serviço de Cirurgia do Aparelho Digestivo
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Cai XJ, et al – Surg Endosc 2008;22:2350-6
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Cai XJ, et al. HepatoBiliary Surg Nutr 2018;7:98-104
DIFFICULTY
DIFFICULTY
Example 1
Example 2
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Carsell KA, et al. BMC Surgery 2009, 9:14-
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Cai XJ, et al. Surg Endosc 2016;30:2894-13
XiuJun Cai – Hangzhou (China) – Junho/2017
ANATOMIC ASPECTS
EXPERIMENTAL MODELS
________________________________________________________________________________ Universidade Federal do Maranhão Serviço de Cirurgia do Aparelho Digestivo
ANATOMIC ASPECTS EXPERIMENTAL MODELS
ANATOMIC ASPECTS
EXPERIMENTAL MODELS
________________________________________________________________________________ Universidade Federal do Maranhão Serviço de Cirurgia do Aparelho Digestivo
ANATOMIC ASPECTS
EXPERIMENTAL MODELS
________________________________________________________________________________ Universidade Federal do Maranhão Serviço de Cirurgia do Aparelho Digestivo
ANATOMIC ASPECTS
LIVER SEGMENTS
________________________________________________________________________________ Universidade Federal do Maranhão Serviço de Cirurgia do Aparelho Digestivo
LAPAROSCOPIC SEGMENTS
ANATOMIC ASPECTS
________________________________________________________________________________ Universidade Federal do Maranhão Serviço de Cirurgia do Aparelho Digestivo
LAPAROSCOPIC SEGMENTS
ANATOMIC ASPECTS
________________________________________________________________________________ Universidade Federal do Maranhão Serviço de Cirurgia do Aparelho Digestivo
LEFT HEPATIC VEIN
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Barretos – São Paulo Novembro 19-23, 2018
LEFT HEPATIC VEIN
Glissonian pedicle
________________________________________________________________________________ Universidade Federal do Maranhão Serviço de Cirurgia do Aparelho Digestivo
LEFT LATERAL SEGMENTECTOMY
________________________________________________________________________________ Universidade Federal do Maranhão Serviço de Cirurgia do Aparelho Digestivo
________________________________________________________________________________ Universidade Federal do Maranhão Serviço de Cirurgia do Aparelho Digestivo
LEFT LATERAL SEGMENTECTOMY
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Nachado MA, et al. 2009
GLISSONIAN PEDICLES
INSTRUMENTS
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Barretos – São Paulo Novembro 19-23, 2018
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Barretos – São Paulo Novembro 19-23, 2018
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Barretos – São Paulo Novembro 19-23, 2018
TECHNICAL ASPECTS
SEGMENT 3
TECHNICAL ASPECTS
SEGMENT 2
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Barretos – São Paulo Novembro 19-23, 2018
TECHNICAL ASPECTS
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Barretos – São Paulo Novembro 19-23, 2018
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Cai XJ, et al. Surg Endosc 2016;30:2894-13
PORTS
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Carsell KA, et al. BMC Surgery 2009, 9:14-
PORTS
PORTS
LEFT TRIANGULAR LIGAMENT
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Barretos – São Paulo Novembro 19-23, 2018
PAREMCHYMA TRANSECTION
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Barretos – São Paulo Novembro 19-23, 2018
ACCESS TO SEGMENT 3
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Barretos – São Paulo Novembro 19-23, 2018
STAPLER
FIRST STAPLER TO SEGMENT 3 (WHITE CARTRIDGE)
PARTIAL TRANSECION OF THE LIVER
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Barretos – São Paulo Novembro 19-23, 2018
SECOND STAPLER TO SEGMENT 2 (WHITE CARTRIDGE)
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Barretos – São Paulo Novembro 19-23, 2018
LEFT HEPATIC VEIN
LEFT HEPATIC VEIN
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Cai XJ, et al. Surg Endosc 2016;30:2894-13
LEFT HEPATIC VEIN
FINAL ASPECT
________________________________________________________________________________ Universidade Federal do Maranhão Serviço de Cirurgia do Aparelho Digestivo
Lençóis Maranhenses
Thanks!