A PERCUTANEOUS TECHNIQUE OF LIVER RETRACTION IN LAPAROSCOPIC BARIATRIC SURGERY
*Hamdy Abd EL Alim Mohammed Farag and Ahmed Abdel Mawgood EL Tokhy
Background: Laparoscopic bariatric surgery requires retraction of the left lobe of the liver to provide adequate
exposure of the hiatus and the stomach. The most common used approaches are use of retractors that require
another incisions and prolonged operative time. Objectives: A prospective assessment of the efficacy and safety of
a percutaneous stone forceps as liver retractor in patients undergoing laparoscopic bariatric surgery. Methods: A
prospective review was performed on 120 patients undergoing bariatric surgery from January2016 to January 2017
in Al azhar university hospitals. A percutaneous stone forceps was used to retract theleft lobe of the liver in all
cases. The retractor can be repositioned as necessary by releasing and regrasping the diaphragm at different sites.
Results: This technique was used in 120 patients from January2016 until january 2017. The average body mass
index was 50 (range:35–65). In all patients, this method was found to be enough to complete the bariatric srgery.
The majority of procedures included laparoscopic Roux-en-Y gastric bypass, sleeve gastrectomy. No intraoperative
liver injuries occurred with use of this technique. Conclusion: Percutaneous retraction of theliver using the
percutaneous stone forceps grasper was found to be safe and effective in those morbidly obese patients. The rate of
complications involving this technique is very low. This novel method provides safe and effective retraction with
less trauma and better cosmesis than conventional technique.
Keywords: bariatric surgery, liver retraction, percutaneous technique.
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