Segment IVa/VIII liver resection

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.

MRI scans

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3D Model