关键词: 腹腔镜, 解剖性肝切除, 肝中静脉, 显露

Abstract: The key to anatomic hepatectomy lies in determining precise liver transection planes guided by hepatic veins during laparoscopic parenchymal division. The middle hepatic vein (MHV), with its crucial functional role and relatively fixed anatomical position, plays a pivotal role in laparoscopic anatomic hepatectomy and its identification, exposure, and the continuous evaluation/adjustment of transection planes are essential. The challenges in laparoscopic MHV exposure primarily involve understanding MHV anatomical variations, mastering parenchymal dissection techniques, and effectively controlling intraoperative hemorrhage. Meanwhile, factors like limited surgical field and restricted operating space make appropriate surgical approaches particularly critical for MHV identification. Therefore, comprehensive knowledge of MHV anatomy combined with proper techniques for MHV exposure during parenchymal transection contributes to accurate determination of resection planes, reduced intraoperative bleeding, and safe parenchymal division. This integrated approach ultimately achieves the goals of anatomic, functional, and precision-oriented hepatic resection.

Key words: laparoscopy, anatomical hepatectomy, middle hepatic vein, expose