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Background <p>Laparoscopic hepatectomy is a less traumatic, minimally invasive procedure that has been widely used to address liver tumors because of its association with a faster recovery and less bleeding. Although adequate exposure and transposition of the liver ensure a clear surgical field and a successful operation, tumors in S7 present a challenge in that surgeons experience difficulty in exposing such tumors and the operating space is small. We used a modified extracorporeal traction with wires method for use in minimally invasive hepatic resection surgery to improve visibility of the surgical field and therefore reduce the difficulty of surgery. The method involved adjusting the traction force appropriately for transposition of the liver.</p> Methods <p>We reviewed data from 15 laparoscopic hepatic tumor resections performed between January and November 2024. In this paper, we describe the surgical and traction techniques used and evaluate the intraoperative and postoperative course.</p> Results <p>The study population consisted of 9 males and 6 females, and the median mean age was 61.84 ± 11.08 years (Table&#xa0;1). The median body mass index was 25.65 ± 3.14&#xa0;kg/m2, the median tumor size was 3.78 ± 2.09&#xa0;cm, the median operative time was 154.09 ± 31.97&#xa0;min, the median intraoperative blood loss volume was 115.36 ± 51.26&#xa0;ml, and the median hospitalization time was 10.33 ± 2.09 days.No serious intraoperative or postoperative complications occurred, and R0 resection was achieved in all cases. Morevoer, in all cases, the time to set up bandwire extracorporeal traction was less than 3&#xa0;min.</p> Conclusion <p>The bandwire traction technique can provide a more stable surgical field, shorten the surgical time, and reduce the likelihood of surgical trauma. The technique allows safe transposition of the liver and plays an important role in minimally invasive resection of hepatic tumors, highlighting its suitability for widespread clinical applications.</p>

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Modified extracorporeal traction with wires: a method for steering the liver for laparoscopic resection of hepatic tumors in segment 7 (with video)

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年4月24日

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  • Xu Yang,
  • Ayiguli Ruoman,
  • Jin Wu,
  • Sheng Yan,
  • Bo Zhou

摘要

Background

Laparoscopic hepatectomy is a less traumatic, minimally invasive procedure that has been widely used to address liver tumors because of its association with a faster recovery and less bleeding. Although adequate exposure and transposition of the liver ensure a clear surgical field and a successful operation, tumors in S7 present a challenge in that surgeons experience difficulty in exposing such tumors and the operating space is small. We used a modified extracorporeal traction with wires method for use in minimally invasive hepatic resection surgery to improve visibility of the surgical field and therefore reduce the difficulty of surgery. The method involved adjusting the traction force appropriately for transposition of the liver.

Methods

We reviewed data from 15 laparoscopic hepatic tumor resections performed between January and November 2024. In this paper, we describe the surgical and traction techniques used and evaluate the intraoperative and postoperative course.

Results

The study population consisted of 9 males and 6 females, and the median mean age was 61.84 ± 11.08 years (Table 1). The median body mass index was 25.65 ± 3.14 kg/m2, the median tumor size was 3.78 ± 2.09 cm, the median operative time was 154.09 ± 31.97 min, the median intraoperative blood loss volume was 115.36 ± 51.26 ml, and the median hospitalization time was 10.33 ± 2.09 days.No serious intraoperative or postoperative complications occurred, and R0 resection was achieved in all cases. Morevoer, in all cases, the time to set up bandwire extracorporeal traction was less than 3 min.

Conclusion

The bandwire traction technique can provide a more stable surgical field, shorten the surgical time, and reduce the likelihood of surgical trauma. The technique allows safe transposition of the liver and plays an important role in minimally invasive resection of hepatic tumors, highlighting its suitability for widespread clinical applications.