Liver retraction using an L-shaped retractor during sleeve gastrectomy

Area of Science:

• Bariatric Surgery
• Surgical Innovation
• Minimally Invasive Procedures

Background:

• Conventional liver retractors like the Nathanson liver retractor (NLR) and snake liver retractor (SLR) have associated disadvantages in bariatric surgery.
• The development of novel surgical instruments is crucial for improving patient outcomes.

Purpose of the Study:

• To evaluate the efficacy and safety of a newly developed L-shaped liver retractor (LLR).
• To compare the LLR against the NLR and SLR in laparoscopic sleeve gastrectomy.

Main Methods:

• Retrospective study of 140 patients undergoing laparoscopic sleeve gastrectomy (June 2014 - December 2020).
• Patients were categorized into three groups based on the liver retractor used: LLR, SLR, or NLR.
• Comparison of procedural time (PT), AST/ALT elevation, and length of hospital stay.

Main Results:

• The LLR group exhibited the shortest procedural time.
• AST/ALT elevation was more frequent with NLR compared to SLR, and tended to be less frequent with LLR versus NLR.
• The NLR group had a significantly longer hospital stay compared to the LLR group.

Conclusions:

• The L-shaped liver retractor (LLR) shows superiority over conventional liver retractors in sleeve gastrectomy.
• LLR offers potential benefits including reduced procedural time and hospital stay.
• Further investigation into LLR's role in bariatric surgery is warranted.