Resection of a large hepatocellular carcinoma (HCC) located in the central part of the liver could be associated with massive bleeding from the hepatic veins or inferior vena cava (IVC). Our central bisegmentectomy including 5 knacks will be useful. The patient was an asymptomatic 60's year old male with a HCC sized 15cm in diameter located in S458. The three major hepatic veins were strongly compressed by the tumor on dynamic CT scan. The IVC was taped and the total liver was fully mobilized from the IVC (1st knack). Injection of blue dye and ICG into the anterior portal vein revealed the boundary between the anterior and posterior sections, visualized using a fluorescence camera (2nd knack). Transection of the liver was started to divide the boundary between the right anterior and posterior section toward IVC. The surface of the RHV was fully exposed on the dissecting plane to its root, removing the part of the paracaval portion, making a liver tunnel in front of the IVC (3rd knack). The IVC half clamping technique was used if necessary (4th knack). After division of the right anterior glissonean pedicle, the right glissonean pedicle was taped in en bloc manner (5th knack). Then, the liver transection along the right-side of the falciform ligament was done, and the middle hepatic vein was finally divided, and the specimen was extracted. The operative time was 10h 15m, and the blood loss was 1500ml, and no blood transfusion was done. The patient was discharged on day 19.