Hepatic Resection
Objective
In case of tumor to remove:
• Small wedge biopsy
• Local excision of tumors
• A major lobectomy.
Position
Supine.
Anesthesia
General.
Procedure
1. Abdominal or thoracic
abdominal incisions.
2. If a thoracoabdominal
incision, the abdominal portion is incised first.
3. Hepatic artery, portal
vein, major biliary ducts are controlled by vascular forceps.
4. The liver parenchyma
ligate major vascular and biliary channels.
5. Careful technique is
necessary when approaching the posterior surface where the hepatic veins enter
the inferior vena cava.
6. After hemostatsis and the
bile ducts are ligated the exposed pnarenchyma covered by greater omentum.
7. The area is drained.
8. The abdomen is closed in
layers.
Instruments
• General set
• Deep instruments set
• Gastrointestinal set
• Biliary tract set
• Thoracotomy set (for
thoracoabdominal approach)
• Hemoclip appliers
(various sizes and lengths) (Fig. 17.25)
• A CUSA may be required
(Chapter 2 Fig. 2.7).
Any questions be sent to drmmkapur@gmail.com
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