Year: 2026
Type: article
Abstract: (BIPHG). Beginning with pioneering experiences in laparoscopic and robotic liver surgeries, the author highlights key anatomical insights-particularly Laennec's capsule and intersegmental planes-that have advanced surgical precision. Transitioning from laparoscopy-assisted to pure laparoscopic donor hepatectomy illustrated the importance of safety, visualization, and anatomy-guided dissection. Inspired by innovations in intraoperative imaging and microanatomy, the author introduces BIPHG-an innovative tension-based technique utilizing indocyanine green (ICG) fluorescence to define natural intersegmental boundaries along Glissonean branches. This method emphasizes real-time visualization, enabling accurate, minimally invasive, and function-preserving liver resections. The review underscores the significance of standardizing definitions and assessment tools, such as the difficulty score, to facilitate broader adoption. Looking forward, ongoing technological and anatomical advances are expected to further refine these approaches, positioning BIPHG as a promising, safe, and precise strategy in minimally invasive liver surgery. This personal narrative aims to contribute to the continued evolution of anatomy-based, minimally invasive hepatic resection techniques.
DOI: 10.1002/ags3.70180
Authors: Go Wakabayashi, Taiga Wakabayashi
Institution: Ageo Central General Hospital
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,350
OpenAlex ID: W7124935248