A Flexible-Arm Liver Retractor that Provides an Optimal Surgical Field without Postoperative Liver Dysfunction

作者：Kawahira Hiroshi^*; Mori Mikito; Hayashi Hideki; Natsume Toshiyuki; Akai Takashi; Hanari Naoyuki; Horibe Daisuke; Hayano Koichi; Matsubara Hisahiro

来源：Hepato-Gastroenterology, 2013, 60(128): 2016-2018.

DOI：10.5754/hge.13589

• Liver retractor
• Laparoscopic surgery
• Liver dysfunction

Background/Aims: It is important to retract the lateral liver segment during laparoscopic gastrectomy to achieve an,optimal surgical field. Few, retractors cause transient liver dysfunction after surgery; therefore, for an easier and safer procedure, we devised a new liver retractor and implemented a trial clinical application. Methodology: The novel liver retractor Comprises a metallic, flexible arm retractor attached to the operating table and an air compressor which pneumatically moves and fixes the retractor It was inserted directly into the abdominal cavity just below the xiphisternurn to retract the left lobe of the liver anterosuperiorly, thereby exposing the hiatus. Blood samples were collected from: the patients on days 1, 3, and 7 after surgery to assess the levers of the liver enzymes AST and ALT. Results: During laparoscopic gastrectomy, no liver damage was Observed macroscopically: The surgical fields obtained were optimal and efficient for laparoscopic surgery. Notably, it was possible to retract the liver as often as needed. Further, none Of the patients developed postoperative liver dysfunction. Conclusions: The novel flexible-arm retractor provided an optimal surgical field without inducing liver dysfunction.

• 出版日期2013-12