J Gastric Cancer.  2010 Sep;10(3):133-136.

V-shaped Liver Retraction during a Laparoscopic Gastrectomy for Gastric Cancer

• Oh DK
• Hur H
• Kim JY
• Han SU
• Cho YK

Abstract

PURPOSE
The aim of this study was to evaluate the effectiveness of our retraction method for achieving a good operative field for the adequate lymph node dissection during laparoscopic gastrectomy in view of short term surgical outcome.
MATERIALS AND METHODS
This study prospectively enrolled 19 patients who underwent laparoscopic gastrectomy for early gastric cancer. The procedure was simply performed by putting the laparoscopic sigle suture in the phrenoesophageal ligament, and then the string was pulling and tying over the sternum. Surgical outcomes of these patients were evaluated.
RESULTS
Under V-shaped liver retraction, the mean operating time and mean number of retrieved lymph nodes was 166.3 minute and 31.37, respectively. And the results were satisfactory compared to open or conventional laparoscopic gastric surgery.
CONCLUSIONS
V-shaped liver retraction requires no extra port or assistant's hands, and prevents additional injury to any intra-abdominal organ. And this method can easily, efficiently and safely enable to achieve a good operative field for the lymph node dissection near the lesser curvature of the stomach.

Keyword

Gastric cancer; Laparoscopic surgery; Liver retraction; Phrenoesophageal ligament

MeSH Terms

Gastrectomy
Hand
Humans
Laparoscopy
Ligaments
Liver
Lymph Node Excision
Lymph Nodes
Prospective Studies
Sternum
Stomach
Stomach Neoplasms
Sutures

Figure

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  Fig. 1 Strings and port placement for V shaped liver retraction.

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  Fig. 2 The operative field after putting V shaped liver retraction. Gastrohepatic ligament, hepatoduodenal ligament, and esophageal hiatus were fully visualized after liver retraction.

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