title: Step-by-step isolated resection of segment 1 of the liver using the hanging maneuver.
abstract: The caudate lobe can be the origin of primary liver tumours or the sole site of liver metastases. This lobe is anatomically divided into 3 parts: Spiegel's lobe (Couinaud's segment 1), paracaval portion (Couinaud's segment 9), and the caudate process. In this series of 4 cases, we provide a step-by-step description of a surgical technique variation that can be applied to resections of lesions localized in segment 1. We believe that other than size, lesion removal in this hepatic anatomic area, which is difficult to perform, can be done more easily using this new approach because it requires minimal mobilization without unnecessary parenchyma transection of other liver parts. Therefore, it reduces the risk of lesions in the inferior vena cava and the middle hepatic vein and respects adequate margins without the use of clamping maneuvers and in an acceptable surgical time.
authors.affiliation: Hepatic Surgery and Liver Transplant Unit, La Fe University Hospital, Valencia, Spain. rlopezandujar@telefonica.net
authors.forename: Rafael
authors.initials: R
authors.lastname: López-Andújar
authors.forename: Eva
authors.initials: E
authors.lastname: Montalvá
authors.forename: Marcos
authors.initials: M
authors.lastname: Bruna
authors.forename: Montiel
authors.initials: M
authors.lastname: Jiménez-Fuertes
authors.forename: Angel
authors.initials: A
authors.lastname: Moya
authors.forename: Eugenia
authors.initials: E
authors.lastname: Pareja
authors.forename: Jose
authors.initials: J
authors.lastname: Mir
mesh_terms: D000368:Aged; D005260:Female; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D008099:Liver / Q000033:anatomy & histology* / Q000601:surgery; D008113:Liver Neoplasms / Q000556:secondary / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome