fig1

Figure 1. LPD (Liver Parenchymal dissection) using Robotic Harmonic curved shears with caudal approaches for Extended left hemi-hepatectomy: Trans-parenchymal Glissonian first approach. (A) LPD using Robotic Harmonic curved shears; (B-D) Exposure of the left Glissonian pedicle with Maryland and the pedicle is then transected through a laparoscopic Endo-GIA; (E) After the left Glissonian pedicle, the remaining liver was resected along the right side of the middle hepatic vein (MHV) with hanging tape; the MHV was fully exposed on the resection plane; (F) The main root of the MHV is encountered, and LPD with Robotic Harmonic curved shears towards the centre while exposing MHV; (G) MHV is then transected through a laparoscopic Endo-GIA.