CT of focal hepatic injury due to surgical retractor.

Abstract

CT of Focal

Volume change of segments II and III of the liver after gastrectomy in patients with gastric cancer

“…Orr and Williams found parenchymal defects and atrophy in the left lobe of the liver in postoperative CT of 27% of gastric cancer patients who had laparoscopic gastrectomy and 18% of patients who had laparoscopic bariatric surgery, and they related these findings to prolonged usage of Nathanson retractor (9). Yassa and Peters (8) reported that in 10 of 250 patients with open gastrectomy due to gastric cancer, they found focal wedge shaped, rectangular or rounded hypodensities in early postoperative CT images and related these findings to pressure necrosis secondary to surgical retractor usage.…”

Disk suspension method: a novel and safe technique for the retraction of the liver during laparoscopic surgery (with video)

“…The septic state continued for 1 week after the operation. These cases are not common, but we may need to care about safe and effective methods for liver retraction [10].…”

“…Although some liver lifting methods have been reported, obese patients can still experience problems associated with an insufficient operative field, postoperative liver dysfunction, and liver laceration [2][3][4][5][6][7][8][9][10]. Accordingly, we have developed a novel and safe technique for retracting the liver and the falciform ligament simultaneously using a Silicon Disk, snake retractor, and an elastic band.…”

A Novel Technique for Liver Retraction in Laparoscopic Bariatric Surgery

“…Mechanical retractors of various shapes and designs, like the Iron Intern TM and the fan and snake retractors, have been used in laparoscopic upper gastrointestinal and bariatic surgeries to displace the left lobe of the liver and to provide an adequate view of the operative field [4,5]. Mechanical retractors deployed using the subxiphoid approach provide good visualization; however, they have potential limitations, including postoperative pain, wound-related complications, and iatrogenic liver injuries [2,6]. Sakaguchi et al described a J-shaped retractor to lift the left lobe of the liver during laparoscopic gastrectomy for gastric cancer, also using a drain and sutures [7].…”