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Thiruchelvam et al. Hepatoma Res 2021;7:22 I http://dx.doi.org/10.20517/2394-5079.2020.144 Page 7 of 18

A B

C D

Figure 5. Laparoscopic right/left hepatectomy including living donor liver transplant (LDLT). The use of 5-6 trocars for laparoscopic
[8]
right hepatectomy proposed by Soubrane et al. (A). Port placements utilised for laparoscopic right hepatectomy for HCC with bile
duct tumour thrombus [20] (B). Port placements for LDLT for both right and left hepatectomy described by surgeons from Seoul National
University Hospital, South Korea [21-23] (C). Port placements for LDLT for right hepatectomy described by surgeons from Samsung
Medical Centre, South Korea [24,25] (D).

for rapid application and release of the tourniquet. In some instances, surgeons may prefer to exteriorise
the tourniquet through the abdominal wall without a port, however, care must be taken to ensure a snug
incision such that there is no leakage of pneumoperitoneum.

Here, we provide examples of previously described port placements for varying resection types.

Resections typically performed in the supine (split-leg or modified Llyod-Davies) position
Laparoscopic right/left hepatectomy including living donor liver transplant
An optical camera is placed along the anterior axillary line to align the resection line along the Cantlie line.
Pfannenstiel incision is used for specimen extraction. Pringle’s manoeuvre is applied, if required [Figure 5A].

In patients with a smaller abdominal domain, it may be difficult to achieve adequate spacing between the 4
main subcostal ports, as in Figure 5A, hence the assistant working port can be shifted to the left subcostal
margin [Figure 5B].