Laparoscopic Anatomical Resection of Liver Segment IV Guided by Key Venous Landmarks.

Authors

Yu Zheng, Jiayi Wu, Maolin Yan

Published in

Annals of surgical oncology. Jul 13, 2026. Epub Jul 13, 2026.

Abstract

Laparoscopic anatomical resection of segment IV remains challenging because of its complex anatomy and lack of reliable intraoperative landmarks [¹]. We present a novel technique that uses the umbilical fissure vein (UFV) and middle hepatic vein (MHV) as primary guides to achieve accurate resection boundaries.
The procedure consisted of four key steps: (1) left-sided parenchymal transection along the UFV; (2) dissection of the hilar plate from the left transection plane to individually ligate segment IV Glissonian pedicles; (3) indocyanine green fluorescence to demarcate the ischemic boundary; (4) right-sided parenchymal transection guided externally by the ischemic line and internally by the MHV.
The operation was completed successfully, with no intraoperative complications and an uneventful postoperative recovery.
Laparoscopic anatomical segment IV resection guided by the UFV and MHV appears safe, feasible, and effective.

PMID:
42443704
Bibliographic data and abstract were imported from PubMed on 14 Jul 2026.

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