Access to the Male Left Anterior Lateral Liver Segment from an Inferior Viewpoint

Description

Oriented from an inferior viewpoint, the left hepatic lobe comes forward as the left anterior lateral segment (Couinaud segment III), bounded medially by the plane of the falciform ligament and laterally by the sharp left margin of the liver. The visceral surface typically brings the fissure for the ligamentum teres (round ligament) into view running toward the umbilical portion of the left portal vein, with the gastric impression lying posterior and medial to the free edge. Anteriorly and inferiorly, segment III curves toward the inferior border, where peritoneal reflections and the adjacent left triangular ligament region define surgical exposure. Segment III matters because it is a frequent target in anatomic left lateral sectionectomy (segments II and III) and in living donor procurement of the left lateral segment for pediatric transplantation. Clear recognition of the segment III territory on the inferior surface helps you anticipate the course of the left hepatic pedicle and avoid misidentifying the umbilical fissure as a safe transection line when variant portal branching or an accessory left hepatic artery is present. Bleeding control depends on this anatomy. Use this illustration for hepatobiliary surgery teaching on Couinaud segmentation, operative approaches to the left lateral section, and segment-based reporting in radiology or surgical oncology manuscripts discussing wedge resection versus segmentectomy for peripheral lesions. It also fits anatomy and dissection manuals that emphasize visceral surface landmarks, including the fissure for ligamentum teres and the left margin as orientation points during inferior exposure. Anatomical accuracy verified by SciePro's Medical Advisory Board.