Question:medium
A surgeon removes a part of the liver to the left of the falciform ligament. Which segments has the surgeon removed?
A surgeon removes a part of the liver to the left of the falciform ligament. Which segments has the surgeon removed?
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Liver to the left of the falciform ligament is the left lateral section, Couinaud segments II and III.
Updated On: Jun 24, 2026
- 1 & 4a
- 2 & 3
- 1 & 4b
- 1 & 3
Show Solution
The Correct Option is B
Solution and Explanation
Approach this by translating an anatomical landmark into the Couinaud segment numbers. The falciform ligament is the visible fold on the front of the liver that historically divided it into right and left lobes. Anything lying to the left of this fold belongs to the anatomical left lobe of the liver.
In the functional Couinaud scheme, the left lateral section sitting to the left of the falciform ligament consists of segment II (superior) and segment III (inferior). So a resection that takes the liver tissue left of the falciform ligament is removing segments II and III.
This operation has formal names: left lateral segmentectomy, or in the Brisbane 2000 terminology, left lateral sectionectomy. It is a frequently performed sublobar resection.
Rule out the other answers using two facts. First, segment I is the caudate lobe, which wraps around the inferior vena cava on the posterior aspect and is not a left lateral structure, so any choice that includes 1 is excluded. Second, segment IV with its 4a and 4b subdivisions sits to the right of the falciform ligament (between it and the gallbladder fossa), so choices with 4a or 4b are excluded as well. Only the pairing of 2 and 3 survives.
\[\boxed{2\ \&\ 3}\]
In the functional Couinaud scheme, the left lateral section sitting to the left of the falciform ligament consists of segment II (superior) and segment III (inferior). So a resection that takes the liver tissue left of the falciform ligament is removing segments II and III.
This operation has formal names: left lateral segmentectomy, or in the Brisbane 2000 terminology, left lateral sectionectomy. It is a frequently performed sublobar resection.
Rule out the other answers using two facts. First, segment I is the caudate lobe, which wraps around the inferior vena cava on the posterior aspect and is not a left lateral structure, so any choice that includes 1 is excluded. Second, segment IV with its 4a and 4b subdivisions sits to the right of the falciform ligament (between it and the gallbladder fossa), so choices with 4a or 4b are excluded as well. Only the pairing of 2 and 3 survives.
\[\boxed{2\ \&\ 3}\]
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