Totally laparoscopic left hepatectomy using the Torsional Ultrasonic Scalpel

Figure 1 Magnetic resonance imaging showing the liver lesion in segments III/IV. Note the mass effect on the middle and left hepatic veins.

Figure 2 Patient positioning and trocar placement.

Figure 3 The operation. A and B: Identification, dissection, and clip ligation of the replaced left hepatic artery; C: Dissection of the left portal vein; D and E: Parenchymal transection using the Lotus Ultrasonic Scalpel; F: Dissection of the left hepatic vein.

Figure 4 Left hepatectomy specimen (segments II-IV).