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An original technique of liver retraction in laparoscopic esophagogastric surgery

N Tanigawa, MD, PhD, FACS
Epublication WebSurg.com, Nov 2009;09(11). URL: http://websurg.com/doi/vd01en2793

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  • 2009-11-16
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Adequate exposure enables an operation to be performed safely and with precision. In most of the upper abdominal operations, good retraction of the hepatic lobe is necessary. A simple, effective and inexpensive method of liver retraction is clearly described in this video. We apply a hand-made liver retractor for access and visualization particularly around lesser curve and esophageal hiatus. A 17cm long and 6mm large penrose drain is used. Our hand-made drain is prepared preoperatively by fixing 3 heavy ties along its length. The middle tie is passed superiorly through a dissected gap in the left triangular ligament while the other ties are separated laterally for retraction of the left lobe of liver. Fine adjustments are made to achieve adequate exposure of the lesser curve and diaphragmatic hiatus.