LAUSR

With technological advances in laparoscopic hepatectomy and new navigation devices, such as fl exible laparoscopic ultrasound probes, indocyanine green (ICG)- fl uorescent imaging and three-dimensional imaging, laparoscopic segmentectomy (LS), which maximizes the preservation of the functional hepatic reserve and the possibility for future repeat hepatectomy while ensuring adequate surgical margins, has become a feasible alternative to hemihepatectomy for addressing hepatocellular carcinoma (HCC). [1,2] However, for a single HCC invading two or more (sub)segments in the left lobe, most surgeons automatically choose left hemihepatectomy (LH) without considering the tumor ’ s anatomical distribution due to the relatively smaller volume of the left lobe. In fact, 80% to 90% of HCC patients in China have underlying cirrhosis. [3] Studies have proven that approximately one-third of postoperative hepatic dysfunction or even failure in patients with cirrhosis is attributed to LH. [4,5] As a result, in the current era of minimally invasive surgery, a more precise algorithm is needed to guide the surgical strategies for HCC in the left lobe. Herein, we proposed a new classi fi cation-oriented laparoscopic anatomical hepatectomy strategy for a single HCC invading two or more (sub) segments in the left lobe, termed the Wu ’ s classi fi cation. A new classi fi cation