Background : In laparoscopic liver resection the method (i.e., anatomical resection, and non-anatomical resection) had no impact on risk of recurrence or survival. Laparoscopic liver resection of right posterior segment is challenging, and non-anatomical transparenchymal trasection can be a reasonable procedure with accurate efficacy and high safety. This case is about laparoscopic transparenchymal tumorectomy performed on segment 7 of the liver.

Methods : A 42-year-old woman was referred for treatment of a single nodular tumor located in the segment 7 of the liver. In the preoperative imaging test the nodule is diagnosis as focal nodular hyperplasia or hepatic adenoma rather than malignancy. Given the suspected benign nature of the tumor and its location beyond the 2nd order branch of the Glisson pedicle, we decided laparoscopic transparenchymal tumorectomy over an anatomical resection. The surgical procedure involved the following steps: (1) Identification of tumor by intra-operative laparoscopic ultrasound (2) Dissection and ligation of hepatic vein branch draining from the tumor (3) Ligation of small peripheral branch entering the tumor. (the main segmental Glisson branch was preserved) (4) Transparenchymal tumorectomy following tumor margin (5) Check ICG (Indocyanine green) for preserved remnant liver perfusion.

Results : The operation time was 150 minutes with a blood loss of 100ml. The final biopsy confirmed Focal nodular hyperplasia with a clear surgical margin. The follow up image showed no ischemic change or any other abnormalities in the remnant liver. The patient discharged without any complication.

Conclusions : Laparoscopic transparenchymal tumorectomy can be alternative for anatomical resection in patients with benign tumor of the liver.