Surgeons can effectively navigate complex liver anatomy using the Arantius-first approach, particularly with right-sided ligamentum teres (RSLT).

• RSLT occurs in about 0.43% of patients, complicating conventional techniques.
• The Arantius-first approach enhances visibility and control, reducing the risk of injuries during laparoscopic left hemi-hepatectomy.

Effective application of this method can improve surgical outcomes in patients with atypical anatomical variations.

• A successful case involved an 80-year-old man with hepatocellular carcinoma, demonstrating the technique’s practicality.