No abstract

The right hepatic lobe transplantation is usually the procedure of choice to provide adequate liver volume to the recipient. Variant vascular and biliary anatomy is more common in the right lobe. Knowledge of anatomical variants is valuable in preoperative planning, particularly in considering donor candidates for adult-to-adult liver transplantation, whereby typically the right lobe of the donor is transplanted to the recipient. The present study was done to identify the branching patterns of right portal vein and to know their importance in management of living donor liver transplantation surgeries. Material and Methods:The present study was conducted on 84 liver specimens of human cadavers fixed with 10% formalin, collected from the Department of Anatomy and Forensic Medicine, MMC&RI, Mysore.Results: Bifurcation of RPV was seen in 30 specimens (35.7%). Trifurcation of RPV was seen in 5 specimens (6%). Quadrification of RPV was seen in 18 specimens (21.4%). Arched pattern of RPV was seen in 15 specimens (17.9%). Premature origin of segment V and segment VIII vein from RPV, then trunk of RPV dividing terminally into segment VI and segment VII vein was seen in 2 specimens (2.4%). Unusual pattern of division of RPV was seen in 10 specimens (12%). In rest of 4 specimens there was no RPV as Right anterior and Right posterior portal veins were directly arising from Main portal vein. Conclusion:Anatomical variations of the liver vasculature and bile ducts are common and their recognition and management is critical in living donor liver transplantation. Although anomalies of the right lobe are commonly encountered, a relatively limited number of cases will significantly complicate the resection and transplantation. Main advantage of right lobe transplantation is the large size of graft and surgical management of both donor and recipient anatomical variations is considerably simpler than with left sided graft.

Background: The knowledge of variations in the origin and course of cystic artery is important for the surgeons as uncontrolled bleeding from the cystic artery and its branches can be fatal during cholecystectomy. Intra operative bleeding can result in an increase in the risk of intra operative injury to vital vascular and biliary structures. Keeping in view the clinical significance and applied importance of the cystic artery anatomy and to add some more knowledge to the existing ones, the present study was undertaken, to know in detail the level of origin, length, and variations in the course and relation of the cystic artery. Methods: The present study was performed on 100 human liver specimens with intact gallbladder and extrahepatic duct system, obtained after dissection from the cadavers in the Department of Anatomy and from post-mortem cases from the Department of Forensic Medicine, Mysore Medical College and Research Institute, Mysore, over a period of 18 months. Results: Most common source of origin of the cystic artery was the right hepatic artery in 92 cases (92%) followed by aberrant right hepatic artery in 4 cases (4%) and the least common sources observed were the left hepatic artery in 1 case (1%) and the gastroduodenal artery in 1 case (1%).Mean length of the cystic artery was 17.6 mm and ranged between 3.7 mm to 42 mm. Out of the 100 dissected specimens, in 65 (65%) the cystic artery was found inside the Calot’s triangle and in 35 (35%) outside the triangle. Conclusion: This study provides details of the normal as well as the variant anatomy of the cystic artery, knowledge of which is very essential for the surgeons to minimize the risk of injury to the blood vessels and the biliary apparatus during cholecystectomy. [Int J Res Med Sci 2013; 1(4.000): 424-428

During routine cadaveric dissection done for the undergraduate students in 2013, at the Department of Anatomy, Mysore Medical College and Research Institute, Mysore an accessory muscle head in the left forearm of a male cadaver was observed which was supplied by a branch of anterior interosseous nerve. Gantzer's muscle is an accessory portion of the flexor pollicis longus or flexor digitorum profundus muscle located in the forearm which is considered an anatomical variant. The adequate knowledge regarding muscular variations is essential not only for anatomists but also for surgeons while approaching forearm for tendon transfer of flexor digitorum superficialis or anterior approach of elbow.