Mini-mesohepatectomy for colorectal metastasis invading the middle hepatic vein at the hepatocaval confluence: educational video demonstrating IOUS use in modern hepatic surgery.

摘要

Makuuchi's (MM's) first report on the use of intraop-erative ultrasonography (IOUS) for hepatectomy was published in 1982. Since then, MM has been stressing the importance of IOUS in the field of hepatic surgery, firmly believing that "those who conquer IOUS technique, conquer modern hepatic surgery." However, educational opportunities in IOUS for surgeons are limited, and depend greatly upon their individual and intentional effort. Torzilli et al., in their educational video manuscript, present us with a new surgical approach for tumors invading middle hepatic vein (MHV) at caval confluence, making full use of extensive and highly specialized ultrasonographical maneuvers. Ultrasound is here used to explore the liver for both staging and confirmation of tumor relations. The up-to-date technique is also utilized in planning surgical strategy.