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Liver retraction using n-butyl-2-cyanoacrylate glue during single-incision laparoscopic upper abdominal surgery
1Second Department of General Surgery, Shengjing Hospital of China Medical University, 36 Sanhao Street, Heping District, Shenyang City, 110004, Liaoning Province, China.
Background:
Liver retraction is critical in single-incision laparoscopic upper abdominal surgery. Several techniques have been reported. Some need an additional port, whereas others are complicated and time-consuming.
Methods:
n-Butyl-2-cyanoacrylate (NBCA) glue was applied to bond the left lateral lobe of the liver to the diaphragm in different single-incision laparoscopic upper abdominal procedures. Liver adhesion time and duration of operation were recorded, and preoperative and postoperative liver function tests carried out.
Results:
All procedures were completed successfully without additional ports or special instruments. The technique provided adequate workspace and a clear view. Mean liver adhesion time was 1·5 min. The maximum operating time was 310 min. Levels of alanine and aspartate aminotransferases were raised on day 1 after surgery but had returned to normal by day 7.
Conclusion:
Creating adhesion between the left lateral lobe of the liver and the diaphragm using NBCA glue is a simple, safe and effective way of achieving liver retraction in single-incision laparoscopic upper abdominal surgery.
