Fig. 2.

Demonstrates the surgical technique for MMH. Following mobilization of the liver by division of the right and left triangular ligaments the precise relationship between the tumour/lesion and hepatic veins is confirmed using intra-operative ultrasound. Principally it is ensured that the right and left hepatic veins and liver hilum are clear of the tumour/lesion. The transection line (dashed line) is then used to resect the lesion/tumour with partial resection of segment 4a and 8 and concomitant resection of the MHV at its origin hence obtaining oncologically clear margins with a non-anatomical rescetional approach.