Published online Dec 21, 2016. doi: 10.3748/wjg.v22.i47.10267
Peer-review started: August 12, 2016
First decision: September 12, 2016
Revised: September 27, 2016
Accepted: October 31, 2016
Article in press: October 31, 2016
Published online: December 21, 2016
Core tip: Laparoscopic liver resection for posterosuperior tumors is technically challenging because this area is located in the bottom of the small subphrenic cage, overlaid by the right liver. Thus, obtaining a fine surgical view is difficult and manipulation of the right liver is required to ensure hemostasis and obtainment of an appropriate surgical margin. The right liver may be handled by the hand-assisted approach, robotic liver resection, or a spacer-based approach. Intercostal ports can facilitate a direct lateral approach into the cage and postural changes may help. We successfully apply semi-prone positioning in the caudal approach without intercostal ports.