ABSTRACT
Adequate exposure to the diaphragm and the right upper abdomen requires partial or complete mobilization of the liver and an understanding of associated ligamentous attachments and vascular structures. Since the bare area of the liver is retroperitoneal, it is rarely involved by the peritoneal spread of ovarian cancer, provided that the liver has not been mobilized in a previous surgery. As such, the bare area can be used to surgical advantage to demarcate the inferior border of a peritonectomy resection or incorporated as the lower margin of closure when reapproximating a fullthickness defect in the muscle. e position of the liver in the abdomen is maintained by ligamentous attachments, which dene the bare area, combined with vasculature structures and intra-abdominal pressure. e liver is attached to the anterior abdominal wall, abdominal viscera, and diaphragm by the falciform ligament, the ligamentum teres
Figure 10.2 Operative findings of stage IIIC epithelial ovarian cancer metastatic to the right diaphragm.
