Hepatoduodenal ligament lifting technique using the round ligament of the liver during laparoscopic liver resection for hepatic caudate lobe tumor.

Laparoscopic liver resection is increasingly favored as the standard of care for liver tumors; however, achieving a good surgical field remains challenging if the resection line is in the paracaval portion of caudate lobe. Here, we report a hepatoduodenal ligament lifting technique using the round ligament of the liver to secure the surgical field. As the caudate lobe was excised from the right side, the elongated round ligament of the liver was passed from left to right behind the hepatoduodenal ligament, and the Endoloop ligated to the distal end of the round ligament was pulled and fixed to the left upper abdomen. The caudate lobe was excised from the left side, and the reverse procedure was performed. These techniques facilitate hepatic dissection in this area by applying appropriate tension between the hilar plate and the liver, and the stable exposure of the posterior aspect of the hepatoduodenal ligament.