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A Simple Method of Liver Retraction for Various Types of Laparoscopic Upper Gastrointestinal Surgeries: The Prolene
Jeong-Sun Lee1, Jin-Jo Kim, Seung-Man Park
1Department of Surgery, Bucheon St. Mary's Hospital, The Catholic University of Korea, 327 Sosa-ro, Wonmi-gu, Bucheon-si, Gueonggi-do, 420-717, Korea, sweetdrops@catholic.ac.kr.
Abstract:
This study describes a safe and the simple method for liver retraction during various types of laparoscopic upper gastrointestinal surgeries. The technique was performed using only a 75 cm 2-0 prolene suture, which was passed through the abdominal wall with a straight needle at the two points of the epigastrium and at the pars condensa of the gastrohepatic ligament without any protective material or knotting. Seventy-six patients who underwent various types of laparoscopic upper gastrointestinal surgeries from August, 2012 to March, 2013 at Incheon St. Mary's Hospital were included in the study. The mean time for the liver retraction was 2.7 ± 0.6 min. Among the 76 cases, complication of this method was one case of the puncture site bleeding on the abdominal wall. The mean levels of alanine aminotransferase and aspartate aminotransferase on the day of the surgery were 54.9 ± 26.3 U/L and 45.2 ± 23.1 U/L, respectively, and these had decreased to 22.4 ± 13.2 U/L and 21.8 ± 14.0 U/L, respectively, on the fourth postoperative day. The prolene hanging-up method is very simple and safe, and it can be used in various types of laparoscopic upper gastrointestinal surgeries.
Insights
A new prolene hanging-up method offers safe and simple liver retraction for laparoscopic upper gastrointestinal surgeries. This technique minimizes operative time and shows minimal complications, making it a valuable surgical approach.
Area of Science:
- Surgical Techniques
- Minimally Invasive Surgery
- Gastrointestinal Surgery
Background:
- Effective liver retraction is crucial for visibility and safety in laparoscopic upper gastrointestinal surgeries.
- Existing methods may be complex or associated with specific complications.
- A need exists for a simpler, safer liver retraction technique.
Purpose of the Study:
- To describe and evaluate a novel, simple, and safe method for liver retraction.
- To assess the efficacy and safety of the prolene hanging-up technique in laparoscopic upper gastrointestinal surgeries.
Main Methods:
- A technique using a 75 cm 2-0 prolene suture passed through the abdominal wall and gastrohepatic ligament was employed.
- The method was performed without protective material or knotting.
- Seventy-six patients undergoing laparoscopic upper gastrointestinal surgery were included.
Main Results:
- The mean time for liver retraction was 2.7 ± 0.6 minutes.
- Complications were minimal, with one case of puncture site bleeding.
- Postoperative liver enzyme levels (ALT and AST) showed a significant decrease by the fourth day.
Conclusions:
- The prolene hanging-up method is a simple and safe technique for liver retraction.
- This method is applicable to various laparoscopic upper gastrointestinal surgeries.
- The technique demonstrates a favorable safety profile and efficiency.
