The concave line of demarcation following the color change subsequent to ligation of the blood supply may be superficially outlined with a cautery. Starting at the inferior border of the line of demarcation, deeply placed mattress sutures are inserted to control bleeding. The mattress sutures must be tied to compress the liver substance but not to crush it, thus leading to more bleeding. After three or four mattress sutures are placed on either side of the lower end of the zone of demarcation, the liver tissue is divided with an ultrasound dissector, laser, or electrocautery unit (Figure 8). Larger vessels and branches from the middle hepatic vein may require double ligation. Surface coagulation may be obtained with an argon beam electrocautery device. Alternatively, the hepatic parenchyma can be transected using multiple applications of an endoscopic cutting linear stapler with vascular loads. This approach should only be used after clear mapping of the internal vascular anatomy using the ultrasound probe. After all bleeding and bile leakage has been controlled (Figure 9), the omentum may be brought up to cover the raw surface of the left lobe. Sufficient sutures are taken to secure the omentum in place.