To best see in the RUQ, the patient should lie in the reverse Trendelenburg position with the body tilted with the right side up. First, the liver should be assessed overall for its shape, size, and surface texture (Figure 7.1). Also demonstrable is the under surface of the right diaphragm (Figure 7.2). Generally, the umbilical port is best for doing this, with instruments in the other ports used for lifting up the edge of the liver and looking underneath at the porta hepatis, and the gallbladder (Figure 7.3, see color plate). Also visible is the hepatic flexure of the
right colon with the duodenum, in thinner patients the pancreatic head, gallbladder, and the inferior aspect of the right lobe of the liver (Figure 7.4, see color plate).
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