Obliteration of the Falciform Ligament

Surgical video case: physiologic variants of the falciform ligament are very rare. There have been a few case reports of obliteration of the falciform ligament where the liver appeared to lack the fissure the ligament usually creates. There have also been anatomic variants pertaining to structures carried in the falciform ligament. However, most variants are not clinically significant and would most often be incidental findings during surgery or imaging used to help diagnose another condition. The falciform ligament serves as an anatomical landmark during abdominal surgery. The hepatic veins, which are hidden from view on the bare surface of the liver and drain into the inferior vena cava, are located immediately inferior to the falciform ligament. Additionally, the round ligament located in the free margin of the falciform ligament enters the umbilicus and serves as a significant landmark for the inner anterior abdominal wall. It also acts as an important landmark during gallbladder surgeries.