腹腔镜第 7 段切除术一直是一项技术上具有挑战性的手术（Li 等人，J Gastrointest Surg 23:1084-1085, 2019）。我们采用背侧入路原位劈开腹腔镜第 7 段切除术。患者为一名 26 岁男性，诊断为位于第 7 段的肝局灶性结节性增生。病灶尺寸约为 6.7 cm × 5.7 cm，接近右尾状叶。首先，通过 Rouviere 沟结合尾状叶优先入路暴露第 7 段椎弓根，然后进行夹闭以确认分界。开始背侧周围实质横切，发现第 6 节和第 7 节之间的节间静脉。该静脉向其根部的解剖优先在背侧进行。然后切断第 7 段蒂，然后朝颅侧进行实质横断，找到受压的右肝静脉 (RHV) 的主干。进一步从躯干向周边解离，暴露并切断其引流节段 7 的分支。随后沿暴露的 RHV 分离颅腹侧剩余的实质。最后，通过分割右侧肝周韧带完成第7段的切除。手术时间为395分钟，预计失血量为500毫升。患者围手术期未接受输血。术后第十天拆线出院，未出现术后出血、肝功能衰竭等并发症。背侧入路联合原位劈开进行腹腔镜第7段切除是可行的，具有一定的优势（Cao等，Surg Endosc） 35：174-181，2021；Liu 等人，Surg Oncol 38：101575，2021；Yang 等人，Surg Endosc 37：1334-1341，2023。由于存在一些局限性，需要进一步调查。© 2024。外科肿瘤学会。

Laparoscopic segment 7 resection has been a technically challenging procedure (Li et al. in J Gastrointest Surg 23:1084-1085, 2019). We introduce a dorsal approach with in situ split for laparoscopic segment 7 resection.The patient was a 26-year-old male diagnosed with hepatic focal nodular hyperplasia located in segment 7. The lesion, measuring approximately 6.7 cm × 5.7 cm, was close to the right caudate lobe. Firstly, the segment 7 pedicle was exposed through the Rouviere's groove combined with caudate lobe-first approach, followed by clipping to confirm demarcation. Peripheral parenchymal transection at the dorsal side started and the intersegmental vein between segments 6 and 7 was found. Dissection of this vein towards its root proceeded preferentially at the dorsal side. Then the segment 7 pedicle was cut off, followed by parenchymal transection toward the cranial side to find the trunk of the compressed right hepatic vein (RHV). It was further dissociated from the trunk to periphery, exposing and cutting off its branches draining segment 7. The remaining parenchyma at the cranioventral side was subsequently separated along the exposed RHV. Finally, the resection of segment 7 was accomplished by dividing the right perihepatic ligaments.The operative time was 395 min with the estimated blood loss of 500 ml. The patient did not receive perioperative blood transfusion. The patient was discharged on tenth postoperative day following suture removal without experiencing any postoperative bleeding, hepatic failure, or other complications.Dorsal approach combined with in situ split for laparoscopic segment 7 resection is feasible and has certain advantages (Cao et al. in Surg Endosc 35:174-181, 2021; Liu et al. in Surg Oncol 38:101575, 2021; Yang et al. in Surg Endosc 37:1334-1341, 2023). Further investigations are required due to some limitations.© 2024. Society of Surgical Oncology.