How to Tape the Whole Right Segmental Branch

In some individuals, the right segmental branch bifurcates just at its origin into tertiary branches of inferior and superior areas (Figs. 5.34, 5.35). In such individuals, it is sometimes difficult to introduce the forceps around the segmental branch for taping because it is too wide. Also, sometimes we introduce the forceps around the inferior branch only (Fig. 5.36). The superior branch sometimes cannot be seen because it lies deep in the liver.

Fig. 5.34. Example of right segmental branch bifurcation at its origin, showing standard form of segmental branch approaching the liver. Three large segmental branches come into the liver
Fig. 5.35. Another type of right segmental branch bifurcation. In some cases the right segmental branch is bifurcated just at the origin of the right segmental branch. In these cases the branch (*) is hidden
Fig. 5.36. (*) branch is hidden behind the main right segmental branch

For the proficient operator, the following procedure (Fig. 5.37a-g) is recommended. First the middle segmental branch is taped. The right segmental branch is detached from the surrounding liver tissue as much as possible. The primary right branch is taped, and the end of this tape is drawn out under the middle segmental branch, resulting in the taping of the whole right segmental branch.

Fig. 5.37a-h. Taping of whole segmental branch—procedure for the proficient operator. a The middle segmental branch is taped as first step; b The right segmental branch is taped. In some cases, it is difficult to introduce forceps behind the right segmental branch, because of some resistance. Do not insert the forceps by force, and skip to next procedure b

Fig. 5.37a-h. Taping of whole segmental branch—procedure for the proficient operator. a The middle segmental branch is taped as first step; b The right segmental branch is taped. In some cases, it is difficult to introduce forceps behind the right segmental branch, because of some resistance. Do not insert the forceps by force, and skip to next procedure

Fig. 5.37c,d. Whole right primary branch is taped
Fig. 5.37f. The taping of whole right segmental branch is completed
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