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Dig Surg. 2012;29(6):463-7. doi: 10.1159/000345996. Epub 2013 Jan 7.

Modified hanging maneuver using the goldfinger dissector in laparoscopic right and left hepatectomy.

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  • 1Department of General and Hepato-Biliary Surgery, Liver Transplantation Service, Ghent University Hospital and Medical School, Ghent, Belgium. roberto.troisi@ugent.be

Abstract

BACKGROUND:

The liver hanging maneuver is a useful technique to transect the liver parenchyma in an open approach while lifting it with a tape passed between the anterior surface of the inferior vena cava and the liver parenchyma. The hanging maneuver during laparoscopic liver resection is not routinely utilized.

MATERIALS AND METHODS:

We describe the technique and results of a modified hanging maneuver using the Goldfinger dissector in 13 right and 5 left hepatectomies. This technique allowed us to dissect the space between right and middle hepatic veins; to create the infero-superior arcade through the space between the anterior surface of the vena cava and the posterior surface of the liver; to lift the cutting area of the liver from the posterior to the anterior direction; to indicate the parenchymal transection line.

RESULTS:

The median resection time and blood loss were 96 min and 220 ml respectively. No conversion was recorded. Two complications (11%) occurred: a biliary fistula and a respiratory distress syndrome, spontaneously resolved.

CONCLUSIONS:

The modified hanging maneuver for laparoscopic right and left hepatectomy based on the use of the Goldfinger dissector is safe, reproducible, and can facilitate liver dissection during major hepatectomy.

Copyright © 2012 S. Karger AG, Basel.

PMID:
23296062
[PubMed - indexed for MEDLINE]
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