The patient is a 34-year-old female scheduled to undergo a living donor laparoscopic right hepatectomy for an adult recipient. Preoperative planning determined that adequate remnant volume would require leaving the middle hepatic vein in the donor, resulting in 33% future liver remnant. The planned transection plane extends from the right-middle hepatic groove through the gallbladder fossa. To confirm the line of transection, ICG fluorescence is used to visualize the margin of the right hepatic lobe. ICG fluorescence is also used to guide the right hepatic duct division. The patient is placed in a right semi-lateral modified lithotomy position. A double-lumen endotracheal tube is used to independently ventilate the left lung. A right lumbar bean bag is used to elevate the right lobe to aid in the mobilization of the right lobe.

PL_livingRightLapdonor – TVASurg – The Toronto Video Atlas of Surgery

Case Description

The patient is a 34-year-old female scheduled to undergo a living donor laparoscopic right hepatectomy for an adult recipient.
Preoperative planning determined that adequate remnant volume would require leaving the middle hepatic vein in the donor, resulting in 33% future liver remnant.
The planned transection plane extends from the right-middle hepatic groove through the gallbladder fossa.
To confirm the line of transection, ICG fluorescence is used to visualize the margin of the right hepatic lobe.
ICG fluorescence is also used to guide the right hepatic duct division.
The patient is placed in a right semi-lateral modified lithotomy position.
A double-lumen endotracheal tube is used to independently ventilate the left lung.
A right lumbar bean bag is used to elevate the right lobe to aid in the mobilization of the right lobe.