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Hashida et al. Mini-invasive Surg 2024;8:14 https://dx.doi.org/10.20517/2574-1225.2023.139 Page 7 of 8

[2]
approach . Continual achievement of favorable outcomes of laparoscopic hepatectomies requires not only
standardized procedures but also these exclusion criteria.

CONCLUSION
Dissecting the liver parenchyma in the plane where no Glissonean branch runs is crucial, such as in the
intersegmental plane. This is achieved to the greatest extent possible using the back-scoring technique,
which reads the grains of the blood vessels.

DECLARATIONS
Author contributions
Manuscript writing: Hashida K
Manuscript revision, supervision: Honda G
Surgical procedure: Ome Y, Tanahashi T, Ubukata C, Kawamoto Y, Matsunaga Y, Ariizumi S

Availability of data and materials
Not applicable.

Financial support and sponsorship
None.

Conflicts of interest
Honda G reports receiving lecture fees from Johnson and Johnson, Medtronic, and Integra Japan. Hashida
K, Ome Y and Kawamoto Y report receiving lecture fees from Integra Japan. Other authors declared that
there are no conflicts of interest.

Ethical approval and consent to participate
Not applicable.

Consent for publication
Not applicable.

Copyright
© The Author(s) 2024.

REFERENCES
1. Okuda Y, Honda G, Kurata M, Kobayashi S. Useful and convenient procedure for intermittent vascular occlusion in laparoscopic
hepatectomy. Asian J Endosc Surg 2013;6:100-3. DOI PubMed
2. Kobayashi S, Honda G, Kurata M, et al. An experimental study on the relationship among airway pressure, pneumoperitoneum
pressure, and central venous pressure in pure laparoscopic hepatectomy. Ann Surg 2016;263:1159-63. DOI PubMed
3. Pan ZY, Yang Y, Zhou WP, Li AJ, Fu SY, Wu MC. Clinical application of hepatic venous occlusion for hepatectomy. Chin Med J
2008;121:806-10. Available from: https://journals.lww.com/cmj/fulltext/2008/05010/clinical_application_of_hepatic_venous_
occlusion.11.aspx. [Last accessed on 22 Jul 2024].
4. Liu TS, Shen QH, Zhou XY, et al. Application of controlled low central venous pressure during hepatectomy: a systematic review and
meta-analysis. J Clin Anesth 2021;75:110467. DOI PubMed
5. Yoneda G, Katagiri S, Yamamoto M. Reverse Trendelenburg position is a safer technique for lowering central venous pressure without
decreasing blood pressure than clamping of the inferior vena cava below the liver. J Hepatobiliary Pancreat Sci 2015;22:463-6. DOI
PubMed
6. Takasaki K. Glissonean pedicle transection method for hepatic resection: a new concept of liver segmentation. J Hepatobiliary
Pancreat Surg 1998;5:286-91. DOI PubMed
7. Honda G, Ome Y, Yoshida N, Kawamoto Y. How to dissect the liver parenchyma: excavation with cavitron ultrasonic surgical
aspirator. J Hepatobiliary Pancreat Sci 2020;27:907-12. DOI PubMed
8. Honda G, Kurata M, Okuda Y, et al. Totally laparoscopic hepatectomy exposing the major vessels. J Hepatobiliary Pancreat Sci
2013;20:435-40. DOI PubMed