This composite of clinical and cadaveric photographs illustrates the surgical anatomy and mobilization of the liver. Panel A is a cadaveric dissection showing the right lobe (RL) and left lobe (LL) of the liver, with the falciform ligament (FL) and the anterior layer of the coronary ligament (ACL) highlighted. Panels B, C, and D demonstrate steps of liver mobilization and diaphragmatic stripping during open surgery, likely for oncological cytoreduction. Panel B shows the dissection of the ACL and the posterior layer of the coronary ligament (PCL). Panel C visualizes the relationship between the diaphragm, the right lobe (RL), PCL, and the right triangular ligament (RTL) during mobilization. Panel D displays the final appearance of diaphragmatic stripping, characterized by a raw, roughened, and hyperemic surface following the removal of the diaphragmatic peritoneum, often performed in cases of massive metastatic disease. The collection serves as an educational guide for surgeons to identify hepatic ligaments and safely mobilize the liver to access the retroperitoneal space and diaphragm.

An intraoperative clinical photograph displaying an open abdominal surgical field focused on the liver and its supporting ligaments. The image features several anatomical landmarks and pathological findings labeled with arrows and a white bounding box. On the left, the falciform ligament is identified as it attaches to the liver surface. Centrally, within the white box, the umbilical fissure and the ligamentum teres hepatis (round ligament of the liver) are visible. To the right of these structures, a tumor implant is identified at the pont hépatique (hepatic bridge), appearing as an irregular, nodular tissue mass distinct from the surrounding smooth hepatic parenchyma. The tissues exhibit a glossy, reddish-pink appearance typical of live visceral organs during laparotomy. This image serves as a clinical example of hepatobiliary oncology and surgical anatomy, illustrating metastatic or primary tumor distribution within the hepatic fissures and along ligamentous attachments.

A multi-panel medical illustration and clinical photograph detailing the transplant-based surgical approach for radical nephroureterectomy with tumor thrombectomy. The upper panels (A–E) demonstrate liver mobilization steps: division of left and right triangular ligaments, division of the coronary ligament, rolling the right hepatic lobe to the midline, 'piggy-back' dissection of short hepatic veins, and circumferential control of the infrahepatic/retrohepatic inferior vena cava (IVC). A central anatomical diagram and corresponding intraoperative clinical photograph show a right kidney with a level IIIa tumor thrombus extending into the IVC. The lower section illustrates 'En-bloc spleen-pancreas mobilization' and the 'early posterior approach to the renal artery,' showing the medial displacement of the renal unit (green arrow) to facilitate ligation of the renal artery near the aorta. This technique aims to decompress collateral venous networks and provide exposure of the retroperitoneal space for oncological resection.

This composite image consists of an intraoperative ultrasound (IOUS) of the liver (left) and a corresponding anatomical line diagram (right) illustrating segmental liver anatomy and vascular landmarks. The ultrasound displays the ligamentum teres (LT) as a distinct, hyperechoic (bright) linear zone located at the free edge of the falciform ligament. This ligament serves as a key surgical landmark, separating the left medial (LM) segment (Segment 4b) from the left lateral (LL) segment (Segment 3). The umbilical portion of the left portal vein (LPV) is visualized as an anechoic (black) tubular structure terminating at the level of the ligamentum teres. The LPV is shown giving off its terminal segmental branches to supply segments 3 and 4b. The educational focus is on the use of IOUS for precise intrahepatic anatomical localization, identification of the Couinaud segments, and tracking the portal venous pedicles during hepatobiliary surgery.