Surgical Resections

Types of Surgical Operations

The objective of these pages, examples and images is to show that both segmental and major hepatic resection may be accomplished with minimal blood loss and certainly without transfusion in most situations.

Example of Segmental Liver Resections

The patient had a cancer of the sigmoid colon removed and at the time of operation was noted to have a secondary tumour in segment 4 of the liver.

1 - This is an MRI scan showing a solitary secondary deposit located in segment 4 of the liver. Following large bowel surgery the liver tumour was properly staged and 3 months later she was referred for a liver resection.

 An MRI scan showing a solitary secondary deposit

Figure 1A - click image to enlarge

2 - Shows a bloodless excision of segment 4 of the liver.

 Bloodless excision of segment 4

Figure 1A - click image to enlarge

3 - Shows the operative specimen with a tumour nodule in the middle, fully excised with 11mm clearance at the closest point.

 Operative specimen with a tumour nodule in the middle

Figure 1A - click image to enlarge

Major Anatomical Resection

This patient had a primary colon cancer removed 2 years previously. On follow up CT scanning she was found to have a large tumour in the right liver. This was removed by a right hemi-hepatectomy following which she was discharged 8 days later.

1 - An MRI scan showing a secondary deposit in the right liver.

 An MRI scan

Figure 1 - click image to enlarge

2 - Figures 2B and 2C show the operative specimen after sectioning to ascertain the operative margins.

 Operative specimen after sectioning Operative specimen after sectioning

Figures 2b and 2c - click images to enlarge