The recurrence of primary and secondary liver malignoma after partial liver resection remains

a common yet unsolved problem.

The exact mechanisms of tumor formation in the remaining parts of the liver are not understood

so far.

The following mouse model studied the proliferation of secondary liver malignoma after partial

liver resection.

In mice, a liver resection of about 70% is normally compensated by liver hypertrophy

of the remaining parts of the liver within 2-3 weeks.

The endocrine factors which play a role in the liver's regeneration may also induce

the growth of liver malignoma.

This video introduces a method which can be used to investigate the relationship between

liver hypertrophy after resection and tumor growth.

The experiment tried to prove that a partial liver resection accelerates the growth of

liver malignoma.

The shown illustration outlines the muurine liver anatomy.

To achieve a liver volume reduction of 65-70%, resection of the median and left lateral lobe

is necessary.

To induce a liver tumor, a predefined volume of cancerous cells is injected into the inferior

right lobe.

A plexiglass box is used for anesthetic induction.

The mouse is then positioned and the abdomen disinfected.

To provide adequate analgesia, 5 mg per kg body weight of carprophene are administered.

The skin incision is made along the median line of the abdomen, from the area above the

syphoid down to the lower abdomen.

The syphoid is carefully dissected from the surrounding tissue and the abdominal fascia

opened along the linea alba.

A stay suture then fixes the now exposed syphoid bone to a retainer above the animal's head

in order to expose the different liver parts.

The retractor is introduced to spread the abdominal wall apart and gain better access

to the abdominal organs.

A saline soaked cotton swab is used to shift the median lobe downward.

The now exposed falciform ligament is dissected.

Median lobe and left lateral lobe are shifted upward against the diaphragm in order to dissect

the thin membrane between the left lateral lobe and the caudate lobe.

A size 4-0 ligature is placed at the base of the left lateral lobe, which is subsequently

returned to its original position using only the saline soaked cotton swab.

It is now tied up using multiple knots.

A gradual change of the lobe's superficial color to a more cyanotic tone is a sign of

adequately interrupted blood supply.

After trimming the ligature threads, the left lateral lobe is resected by cutting along

the slightly diagonal line along its base.

Now a new ligature is put in place at the median lobe's base.

The lobe is likewise repositioned by applying gentle pressure from above with a cotton swab.

The median lobe is similarly tied up with multiple knots, with the previously described

color change again indicating effective disruption of blood flow.

The ligature threads are trimmed and the lobe is removed.

Because the inferior vena cava runs through the dorsal portion of the lobe, it is prone

to damage by the ligature which may lead to liver necrosis.

This part of the lobe must therefore remain in situ.

The inferior right lobe is demonstrated by moving the intestinal loops to the left.