Surgical Film Library-Left Upper Quadrant & Porta Hepatis Dissection

Video Transcription

Video Summary

The speaker discusses surgical techniques for operating in the left upper quadrant, emphasizing the importance of exposure via an incision up to the xiphoid process and using specialized retractors to lift the costal margin. Detailed knowledge of anatomy is crucial to avoid damaging vital structures like the celiac trunk and its branches (left gastric, splenic, common hepatic arteries) and vascular variations, especially accessory hepatic arteries. Liver anatomy, including the portal vein, hepatic artery, bile duct, and hepatic veins, is reviewed, highlighting preservation of vessels during tumor removal. The ligamentum teres and ligamentum venosum are key sites for tumor involvement, requiring careful dissection to protect vascular inflow. Diaphragm resection risks include injury to the left hepatic vein, phrenic nerve, spleen, and pericardium. A posterior approach to splenectomy is presented, focusing on mobilization of the pancreas tail and safe ligation of splenic vessels. The surgical video demonstrates meticulous lymph node dissection at the porta hepatis, tumor removal from the ligandum teres and venosum, preservation of accessory arteries, and splenectomy to excise tumor-involved tissue.

Asset Subtitle

Oliver Zivanovic, Germany

Meta Tag

Route Open

Skill Level Expert

Surgical Location Upper abdomen

Keywords

Open

Upper abdomen

Expert

left upper quadrant surgery

celiac trunk anatomy

liver vascular preservation

diaphragm resection risks

splenectomy technique