dr. orlando torres...orlando jorge m. torres md, phd full professor and chairman department of...

Orlando Jorge M. Torres MD, PhD

Full Professor and Chairman

Department of Gastrointestinal Surgery

Hepatopancreatobiliary Unit

Federal University of Maranhão - Brazil

LAPAROSCOPIC LEFT LATERAL

SEGMENTECTOMY

________________________________________________________________________________ Universidade Federal do Maranhão Serviço de Cirurgia do Aparelho Digestivo

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Cai XJ, et al – Surg Endosc 2008;22:2350-6

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Cai XJ, et al. HepatoBiliary Surg Nutr 2018;7:98-104

DIFFICULTY

DIFFICULTY

Example 1

Example 2

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Carsell KA, et al. BMC Surgery 2009, 9:14-

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Cai XJ, et al. Surg Endosc 2016;30:2894-13

XiuJun Cai – Hangzhou (China) – Junho/2017

ANATOMIC ASPECTS

EXPERIMENTAL MODELS

________________________________________________________________________________ Universidade Federal do Maranhão Serviço de Cirurgia do Aparelho Digestivo

ANATOMIC ASPECTS EXPERIMENTAL MODELS

ANATOMIC ASPECTS

EXPERIMENTAL MODELS

________________________________________________________________________________ Universidade Federal do Maranhão Serviço de Cirurgia do Aparelho Digestivo

ANATOMIC ASPECTS

EXPERIMENTAL MODELS

________________________________________________________________________________ Universidade Federal do Maranhão Serviço de Cirurgia do Aparelho Digestivo

ANATOMIC ASPECTS

LIVER SEGMENTS

________________________________________________________________________________ Universidade Federal do Maranhão Serviço de Cirurgia do Aparelho Digestivo

LAPAROSCOPIC SEGMENTS

ANATOMIC ASPECTS

________________________________________________________________________________ Universidade Federal do Maranhão Serviço de Cirurgia do Aparelho Digestivo

LAPAROSCOPIC SEGMENTS

ANATOMIC ASPECTS

________________________________________________________________________________ Universidade Federal do Maranhão Serviço de Cirurgia do Aparelho Digestivo

LEFT HEPATIC VEIN

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Barretos – São Paulo Novembro 19-23, 2018

LEFT HEPATIC VEIN

Glissonian pedicle

________________________________________________________________________________ Universidade Federal do Maranhão Serviço de Cirurgia do Aparelho Digestivo

LEFT LATERAL SEGMENTECTOMY

________________________________________________________________________________ Universidade Federal do Maranhão Serviço de Cirurgia do Aparelho Digestivo

________________________________________________________________________________ Universidade Federal do Maranhão Serviço de Cirurgia do Aparelho Digestivo

LEFT LATERAL SEGMENTECTOMY

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Nachado MA, et al. 2009

GLISSONIAN PEDICLES

INSTRUMENTS

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Barretos – São Paulo Novembro 19-23, 2018

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Barretos – São Paulo Novembro 19-23, 2018

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Barretos – São Paulo Novembro 19-23, 2018

TECHNICAL ASPECTS

SEGMENT 3

TECHNICAL ASPECTS

SEGMENT 2

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Barretos – São Paulo Novembro 19-23, 2018

TECHNICAL ASPECTS

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Barretos – São Paulo Novembro 19-23, 2018

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Cai XJ, et al. Surg Endosc 2016;30:2894-13

PORTS

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Carsell KA, et al. BMC Surgery 2009, 9:14-

PORTS

PORTS

LEFT TRIANGULAR LIGAMENT

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Barretos – São Paulo Novembro 19-23, 2018

PAREMCHYMA TRANSECTION

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Barretos – São Paulo Novembro 19-23, 2018

ACCESS TO SEGMENT 3

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Barretos – São Paulo Novembro 19-23, 2018

STAPLER

FIRST STAPLER TO SEGMENT 3 (WHITE CARTRIDGE)

PARTIAL TRANSECION OF THE LIVER

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Barretos – São Paulo Novembro 19-23, 2018

SECOND STAPLER TO SEGMENT 2 (WHITE CARTRIDGE)

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Barretos – São Paulo Novembro 19-23, 2018

LEFT HEPATIC VEIN

LEFT HEPATIC VEIN

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Cai XJ, et al. Surg Endosc 2016;30:2894-13

LEFT HEPATIC VEIN

FINAL ASPECT

________________________________________________________________________________ Universidade Federal do Maranhão Serviço de Cirurgia do Aparelho Digestivo

Lençóis Maranhenses

Thanks!