Precision hepatectomy is a surgical approach supported by highly developed biomedical and information science technology, which pursues complete removal of the target lesion while minimizing trauma and controlling surgical bleeding, ultimately enabling the patient to achieve the best recovery outcome. This surgical approach is less invasive, greatly reduces intraoperative bleeding, facilitates recovery of liver function, reduces the length of hospital stay, significantly reduces the incidence of complications, greatly reduces the tumor recurrence rate, and increases the 3-year and 5-year survival rate of patients. Not long ago, the Department of Hepatobiliary Medicine of our hospital made a new breakthrough in the application of this technique. Without blocking the blood supply to the hepatic hilum, the tumor was successfully removed for a patient with a huge hepatocellular carcinoma in the right liver that could not be removed by conventional methods. Huang Gang, Department of Hepatobiliary and Pancreatic Surgery, The First Hospital of Guangzhou Medical University, Guangzhou, China, was a 45-year-old female patient named Zhou Moumou. She was admitted to the hospital in June 2013 due to “10 months post-operative colon cancer”. The patient underwent laparoscopic right hemicolectomy at a university hospital in Guangzhou 10 months ago for “colon cancer and metastatic liver cancer”, but the liver tumor was not removed because the liver cancer was close to a large branch of the portal vein, which made the operation difficult and dangerous. After the operation, he underwent 2 courses of standardized chemotherapy, and about 2 months later, he found that the “hepatocellular carcinoma” had increased in size, so he underwent “super-selective hepatic artery chemoembolization” and continued to complete 4 times of chemotherapy for colon cancer after the operation. The patient underwent “super-selective hepatic artery chemoembolization” again 2 months ago and was successfully discharged from the hospital. After discharge, the patient had recurrent occult pain in the right upper abdomen, and the gastrointestinal surgery and hepatobiliary department of the original operating hospital said that the surgery was difficult and could not be removed surgically. After admission, it was found that the tumor was huge, located in the right half of the liver, with a diameter of more than 8 cm, invading the right branch of portal vein and inferior vena cava, caudate lobe and left inner lobe, etc. Only surgical resection of the tumor could save the patient’s life, but the surgery to remove this liver tumor was extremely difficult and dangerous, and required a very high technical level. Only through precise operation can the tumor be removed completely and the patient’s safety can be guaranteed. Through thorough preparation, “precise enlarged right hepatectomy” was performed under general anesthesia at the end of June 2013. The tumor not only completely invaded the right hepatic vein, but also completely invaded the right branch of the portal vein to the bifurcation, and more dangerously, the tumor invaded the inferior vena cava and fused with the wall of the inferior vena cava to form a plate, with an area of about 4cm×3cm, and the tumor also invaded the right segment of the caudate lobe and the left inner lobe. Since the patient had just undergone colon cancer surgery a few months ago, the abdominal adhesions were serious and extensive, which made the surgery even more difficult. Without blocking the blood supply to the hepatic hilum, the tumor was finally removed completely after precise operation, fine dissection, and millimeter by millimeter separation, and there was no blood transfusion during the operation because of small trauma and less bleeding. After the perfect treatment after the operation, the patient did not have any complications and was discharged from the hospital soon after healing, which greatly shortened the hospital stay. According to Dr. Gang Huang, chief physician of Hepatobiliary Department, right hemicolectomy has become a common surgical procedure for treating right hepatocellular carcinoma. However, when the tumor in the right lobe of the liver is larger than 5 cm in diameter and needs to be operated, the traditional method is not only difficult, but also difficult or even impossible to separate the right liver and the tumor, which can easily cause tumor rupture, dissemination, bleeding, tearing or damaging the hepatic vein and inferior vena cava causing uncontrollable hemorrhage. And precision hepatectomy can well solve the above problems. According to Dr. Gang Huang, the basic elements of precision hepatectomy include: precise preoperative evaluation, precise surgical planning, fine surgical operation, and excellent postoperative management. Precision hepatectomy has the following advantages compared with traditional irregular hepatectomy: (1) Reduced trauma: no blocking of the first hepatic hilar or selective blocking avoids ischemia-reperfusion injury to the residual liver tissue; at the same time, precision hepatectomy opens the liver section to avoid ischemic necrosis caused by suturing; whereas traditional irregular hepatectomy uses Pringle method to block the blood flow into the liver, and finger pinching or (2) Ensure the structural integrity of the remaining liver: preoperative imaging technology is used to accurately evaluate the lesion, and intraoperative dissection clearly reveals the intrahepatic vessels and bile ducts, avoiding damage to important vessels, bile ducts and surrounding tissues, and enabling rapid recovery of liver function after surgery; (3) Fine treatment of vessels and bile ducts according to liver anatomy, reducing intraoperative bleeding and intraoperative necrosis. (4) Reduced tumor recurrence rate, improved patient survival rate, and better compliance with tumor-free principle: precision hepatectomy removes the lobe or segment where the tumor is located, reducing the chance of intrahepatic dissemination. (5) Precision hepatectomy requires a high level of surgeon skill and should be chosen according to the patient’s and surgeon’s specific conditions, weighing the safety and risk of the procedure.