This is a method by which part of a segment is resected systematically, taking "cone unit(s)" into consideration, i.e., so-called Couinaud's segment resection. Four or five cone units correspond to one Couinaud's segment. The number of cone units to be resected depends upon the size and location of the tumor.
Here the cone unit resection is explained, using a cauliflower as a model (Fig. 7.1). The trunk of the cauliflower corresponds to the segmental branch of the liver and the stalks represent the liver tertiary branches. Each stalk with the cauliflower clump on top represents a liver cone unit. One of the stalks is ligated and then a dye solution is introduced (Fig. 7.2). The pig-mented part represents a cone unit. The pigmented part is then removed (Fig. 7.3). Figure 7.4 shows a three-cone-unit resection and resected specimen (Fig. 7.5).
Cone unit resection
Transection of the corresponding tertiary branch
Fig. 7.2. (Step 2) One cone unit is pigmented
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