Case Description

• The patient was a 66-year-old male with a history of hepatitis B. He had a hepatocelluar carcinoma on segment 4a/8 measured about 4cm in diameter. An anatomical resection was recommended.
• The optimal surgical resection for parenchymal sparing with adequate margins was an anatomical resection of segments 4a and 8, while portions of segments 4b and 5 maybe included.
• Surface anatomy guides was used to mark three separate transection planes to ensure negative margins and avoid injuries to major vessels.
• Segment 4a/8 pedicles and hepatic veins and branches to the middle hepatic veins were divided during parechymal transection.
• Because the tumour is centred over the middle hepatic vevin (MHV), the MHV will be sacrified once parenchymal transection is completed.