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Figure 10. Totally laparoscopic hemi-hepatectomy of left liver for large tumor. (A) A CT scan showed a hepatocellular carcinoma 12 cm in diameter, mainly located in left lateral section involving umbilical portion. There were several daughter nodules in segment 4; (B) due to the large tumor, left subphrenic space was not well visualized, but orientation of the hepatic hilar portion was preserved. After the individual isolation of the left and middle hepatic artery and the left portal vein, hepatic parenchyma was transected, prior to the mobilization of the left liver; (C) parenchymal transection allowed to tract the left liver to the caudal side; we put an additional trocar on the most cranial side of epigastrium. This was quite helpful for the division of the left triangle ligament; (D) the confluence of the left hepatic vein was also encircled by tape and divided using stapling device