Exposure for Hepatectomy

Advancements in operative technique, instruments, and perioperative care have led to improved outcomes for patients who undergo hepatectomy for colorectal liver metastases (CLM). However, critical to surgical and oncologic safety and success is adequate exposure via effective incisions along with efficient retraction systems. Careful consideration of the goals of exposure and patient benefits of incisions that are available to the liver surgeon is critical for optimal surgical outcomes. In the following chapter, various incisions commonly used for hepatectomy for CLM are reviewed, including a detailed description of the benefits and detriments of each. Furthermore, a detailed description of the “Inverted-L” incision is included, as well as discussion of the benefits of this incision that make the Inverted-L incision the preferred incision for open hepatectomy for CLM.