The document provides an overview of liver anatomy including: - The liver's position in the right hypochondrium and epigastric region and its weight of 1.5kg on average. - It has two surfaces: the diaphragmatic surface against the diaphragm and the visceral surface covered in peritoneum except at the gallbladder fossa and porta hepatis. - The visceral surface is related to other structures like the stomach, duodenum, and right kidney. - Couinaud described the liver as being divided into 8 segments based on arterial, portal, and biliary drainage.

1. Liver Anatomy
Dr. Rahul Jain
M.S. General Surgery

2. Positional Anatomy
– largest visceral organ in the body
– primarily in the right hypochondrium and epigastric region extending
into the left hypochondrium
– weighing 1.5 kg in the average 70-kg man

3. Surfaces of Liver
1. Diaphragmatic Surface
2. Visceral Surface
– Hepatorenal Recess - part of the peritoneal cavity, on
the right side between the liver and the right kidney
and right suprarenal gland.
– Subphrenic Recess - separates the diaphragmatic
surface of the liver from the diaphragm

4. Diaphragmatic Surface
– Smooth and domed, lies against the inferior surface of the diaphragm

5. Visceral Surface
Covered with visceral peritoneum except at 2
places –
1. GB fossa
2. Porta hepatis

6. Visceral Surface (contd.)
Following are the structures related to the visceral
surface of the liver-
– esophagus,
– right anterior part of the stomach,
– superior part of the duodenum, lesser omentum, gall
bladder
– right colic flexure,
– right transverse colon,
– right kidney, and
– right suprarenal gland

7. Bare Area of Liver
Part of liver on diaphragmatic surface where there is no peritoneal covering
between liver and diaphragm
Boundaries –
 Anteriorly : Anterior coronary ligament
 Posteriorly : Posterior coronary ligament

9. SEGMENTAL ANATOMY OF LIVER
– Couinaud, a French anatomist, described the liver as being divided into eight
segments.
– liver is divided by the principal plane, which divides the Organ into
halves of approximately equal size.
– This imaginary line is defined by a parasagittal line that passes through
the gall bladder fossa to the inferior vena cava. It is in this plane that the
middle hepatic vein is found .
– Importantly, the principal plane divides the left half of the liver from the
right half. The lobes of the liver are unequal in size and bear only little
relevance to operative anatomy.

10. – The traditional eight-segment anatomy of the liver relates to the
hepatic arterial, portal, and biliary drainage of these segments.
– Each of these segments can be considered as a functional unit,
with a branch of the hepatic artery, portal vein and bile duct,
and drained by a branch of the hepatic vein.
– The caudate lobe is defined as segment I, and the remaining
segments are numbered in a clockwise fashion upto segment
VIII .

11. LIVER RESECTION
DEFINTION COUINAD’S REMOVED
SEGMENTS
RIGHT HEPATECTOMY V, VI, VII, VIII
LEFT HEPATECTOMY II,III,IV
RIGHT TRISEGMENTECTOMY
(RIGHT LOBECTOMY)
IV, V, VI, VII, VIII
LEFT TRISEGMENTECTOMY II, III, IV, V, VIII
LEFT LATERAL LIVER RESECTION
(LEFT LOBECTOMY)
II, III

12. THANK YOU