How to do repeat hepatectomy for remnant liver recurrence using diaphragmatic incision for right liver mobilization.

In addition to difficulties with parenchymal resection reflecting anatomic disorientation arising from rotation of the liver remnant that accompanies regeneration, repeat resections typically involve difficult and protracted lysis of adhesions. We describe our technique for facilitating right liver mobilization even in the presence of severe adhesions. Lysis of dense retroperitoneal adhesions posterior to the right liver can be performed safely by incising the diaphragm to facilitate manipulations to mobilize the right liver.