Couinard Liver Corrosion cast
Old Ecole de Medecine, Montpelier
As a breast surgeon masquerading as an examiner in General Surgery, the liver segments were my Achilles heel. They were a popular anatomy question, but I couldn’t remember them. Prior to every exam I had to get the anatomy textbooks out. There was a memory trick with the knuckles of a clenched fist, but that just confused me even more. Claude Couinard published his description of the liver segments in 1957. Using post mortum corrosive liver casts, he demonstrated 8 regions or segments of the liver with separate blood supply and bile duct drainage. His technique was to inject the vessels and ducts with vinyl chloride acetate and disolve the liver tissue with acid. Arteries, veins and ducts each had a different colour. The fact that each liver segment was a separate functional and anatomical entity lead to a renaissance of liver resection surgery. Couinard’s weird arrangement of the segments, that I could never recall, was said to be based on the arrondissements of Paris . #caudateisone #letsmakelemonade
Pen Paint and Scalpel 