Related Experiment Video
Updated: Jun 15, 2026
Application of Hemostatic Devices in Laparoscopic Hepatectomy
Published on: April 19, 2022
Modified liver-hanging maneuver designed to minimize blood loss during hepatic parenchymal transection in
Nobuhisa Akamatsu1, Yasuhiko Sugawara, Nobuhiro Shin
1Department of Hepato-biliary-pancreatic Surgery, Saitama Medical Center, Saitama Medical University, Saitama, Japan.
Purpose:
We evaluated the efficiency of a modified liver-hanging technique for minimizing intraoperative blood loss during right and left hemihepatectomy.
Methods:
The lower end of the hanging tape was repositioned between the parenchyma of the left paramedian sector and the hilar plate. The upper end of the tape was positioned between the right hepatic vein and middle hepatic vein for right hepatectomy (Belghiti), and between the middle hepatic vein and left hepatic vein for left hepatectomy. The tape was positioned prior to the parenchymal transection. We compared the results of this operative technique, performed in 15 recent patients, with those of conventional hemihepatectomy performed in 14 earlier patients.
Results:
There were no intergroup differences in baseline characteristics or postoperative outcomes. Intraoperative blood loss (P = 0.02), especially blood loss during the parenchymal transection (P = 0.005), was significantly less in patients undergoing the modified technique. Multivariate analysis revealed that this modified liver-hanging technique offered a significant advantage in blood-loss reduction during parenchymal transection over the conventional techniques (P = 0.005).
Conclusion:
Using the liver-hanging technique during hemihepatectomy could be crucial for liver surgeons.
