FIELD: medicine.
SUBSTANCE: invention relates to surgery and can by applied for left-side. Hemihepatectomy. Cystic plate is dissected. Tissues are divided into layers on the line of liver capsule passage into peritoneum of hepatoduodenal ligament first on upper (right) edge of left lobe pedicle 1 cm to the right from the left border of the 4-th liver segment. Liver capsule is divided into layers on lower (left) edge of left lobe pedicle immediately above ductus venosus Arantii, portal plate of left lobe pedicle is exposed. Liver parenchyma is separated from portal plate on posterior surface of left lobe pedicle and the left lobe pedicle is bypassed. Cord is brought around left lobe pedicle. Branch of open apparatus cassette is introduced into canal between left lobe Glisson's pedicle and liver parenchyma, extending canal for passing cassette by countertraction of lobe pedicle by cord. Apparatus sewing and transaction of lobe pedicle are performed. Peritoneum leaf is dissected between lower edge of left hepatic vein near its orifice and ductus venosus Arantii. By-turn separation of liver parenchyma from left hepatic vein is carried out from medial and lateral sides, forming in such way canal between liver tissue and left hepatic vein near its orifice, through which cord is passed. Branch of open apparatus cassette is introduced into canal between left hepatic vein and liver parenchyma, extending canal for passing cassette by countertraction of left hepatic vein by cord Apparatus sewing and transaction of left hepatic vein are performed. Left-side hemihepatectomy is carried out.
EFFECT: method makes it possible to avoid ischemia of liver, reduce trauma, reduce operation time.
1 ex, 3 dwg
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Authors
Dates
2011-04-20—Published
2009-04-01—Filed