An anatomical laparoscopic approach for en bloc liver resection of segments 7 and 8

PURPOSE: Laparoscopic en bloc resection of liver segments 7 and 8 (S7/8) remains technically demanding because of the deep anatomical location and proximity to major vascular structures. We describe a standardized anatomical approach enabling safe laparoscopic en bloc S7/8 resection. METHODS: Our technique combines dorsal and ventral intrahepatic Glissonean pedicle approaches with preservation of the right inferior hepatic vein (IRHV). After complete mobilization of the right liver, the IRHV and right hepatic vein (RHV) are exposed and controlled. Segmental inflow is selectively managed by encircling the Glissonean pedicles of segments 7 and 8 (G7 and G8), allowing precise anatomical demarcation and parenchymal transection along major hepatic veins and the inferior vena cava. RESULTS: This approach enables secure vascular control, adequate venous drainage, and sufficient oncological margins while preserving functional liver volume. In a representative case, laparoscopic en bloc S7/8 resection was successfully completed without major complications. CONCLUSION: The combined dorsal and ventral intrahepatic Glissonean approach facilitates safe and reproducible laparoscopic en bloc resection of S7/8 and represents a valuable and educational option that may facilitate wider adoption of this technically demanding procedure requiring parenchyma-sparing hepatectomy.