**3. Comments**

84 Updated Topics in Minimally Invasive Abdominal Surgery

Fig. 9. The medial Glissonean pedicle is encircled with an Endo Mini Retract.

Fig. 10. The medial Glissonean pedicle is divided using an endocopic stapler.

Laparoscopic anatomical segmental resection has not been widely accepted due to technical difficulties in controlling each Glissonean pedicle laparoscopically. Previous reports relating to laparoscopic hemihepatectomy have described separate dissection and division of each of the hepatic artery, duct and portal vein [3-6], or an intrahepatic Glissonean approach [12, 13]. The entire length of primary branches of the Glissonean pedicle and the origin of secondary branches are located outside the liver and the trunks of the secondary and more peripheral branches run inside the liver [8]. Therefore, the right, left, anterior, posterior, medial, or lateral Glissonean pedicle can be encircled and divided en bloc extrahepatically. Using an Endo Retract Maxi or Endo Mini-Retract, an extrahepatic Glissonean approach can be safe and feasible. However, each Glissonean pedicles should be divided as distally as possible to avoid biliary injury. The right Glissonean pedicle should not be transacted en bloc but the right anterior and posterior Glissonean branches should be divided respectively. The left Glissonean pedicle should be divided at the root of the umbilical portion to avoid injury of the right hepatic duct. Therefore, the pedicle should be encircled left to the Spiegel branch. In addition, each pedicles show shorter extrahepatic courses, and thus are better divided after some amount of parenchymal dissection.
