This book presents a concept of hepatic segmentation with respect to the Glissonean pedicle tree. It also outlines surgical procedures for segmentectomy and cone-unit resection. Detailed illustrations depict every important action a surgeon must consider while performing these operations.
Professor Takasaki’s technique for liver resection derives from an original
concept of anatomical division of the liver into three segments based on the
distribution of the portal branches. This might seem strange when we have
been used to the Couinaud anatomy for the past 20 years. In fact, however,
there is a close correlation between the two anatomies if we consider that the
right portal branch is short or even nonexistent. We can say that portal blood
is distributed to three portions of the liver: the right segment, the middle
segment, and the left segment for Takasaki; and the right posterior sector,
the right anterior sector, and the left liver for Couinaud.
Thus the liver is
divided into three in both classifi cations.
The second original contribution by Professor Takasaki is the approach
to the portal pedicles inside the liver parenchyma. Initially, I was opening
the Glisson capsule to clamp and ligate the vascular elements independently
but changed many years ago to the Takasaki technique, which is easier,
quicker, and safer. Apart from the Pringle maneuver for the whole liver, this
technique is the best way to control a part of the liver for liver resection in
a real anatomical manner. The video material that accompanies this volume
shows the most common liver resections carried out using this technique
and provides the best illustration of its quality.
