Introduction : Laparoscopic major hepatectomy, especially laparoscopic right anterior sectionectomy or laparoscopic central bisectionectomy with two cut surface are the great challenge area.

Methods : The patient was 46 years old man and diagnosed with 5cm sized HCC between segment 7 and 8 and was performed TACE before surgery. Pringle maneuver was performed during the hepatic parenchymal transection using laparoscopic Bull-dog. During the hepatic transection, the Cavitron Ultrasonic Surgical Aspirator(CUSA) was used. Small hepatic vein branches and small glissonean pedicles were sealed and divided with a THUNDERBEAT™ (Olympus). iDriveTM Ultra Powered Stapling device (Medtronic) was used for division of major glissonean pedicle and large hepatic veins. The specimen was placed in endo-bag and extracted through Pfannestiel incision.

Results : There was no major bleeding during operation and no complication after surgery. The operation time was 338 min, and the estimated blood loss was less than 250 ml. On postoperative day 3, computed tomographic scan showed no pathological findings. The patient was discharged on postoperative day 5 without complications.

Conclusions : The authors suggest that the laparoscopic central bisectionectomy is safe and feasible for HCC