Artikel
Intraabdominal trocar-free vacuum liver retractor for upper gastrointestinal surgery: Preliminary clinical series using the LiVac® System (VIDEO)
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Autoren
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Christian Benzing
- Charite Universitätsmedizin Berlin, Campus Virchow Klinikum, Klinik für Allgemein-, Viszeral- und Transplantationschirurgie, Berlin, Deutschland
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Felix Krenzien
- Charite Universitätsmedizin Berlin, Campus Virchow Klinikum, Klinik für Allgemein-, Viszeral- und Transplantationschirurgie, Berlin, Deutschland
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Sascha Chopra
- Charite Universitätsmedizin Berlin, Campus Virchow Klinikum, Klinik für Allgemein-, Viszeral- und Transplantationschirurgie, Berlin, Deutschland
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Johann Pratschke
- Charite Universitätsmedizin Berlin, Campus Virchow Klinikum, Klinik für Allgemein-, Viszeral- und Transplantationschirurgie, Berlin, Deutschland
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Ricardo Zorron
- Charite Universitätsmedizin Berlin, Campus Virchow Klinikum, Klinik für Allgemein-, Viszeral- und Transplantationschirurgie, Berlin, Deutschland
| Veröffentlicht: | 21. April 2016 |
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Gliederung
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Background: In laparoscopic upper gastrointestinal (GI) surgery, an adequate retraction of the liver is crucial. Especially in single-port surgery and obese patients problems may occur during liver retraction. The current study seeks to evaluate the efficacy and safety of the LiVac ® trocar free liver retractor in laparoscopic upper GI surgery.
Materials and methods: The present study is a non-randomized dual-center clinical series describing our preliminary results using the LiVac® System for liver retraction. The primary endpoints of the present study included the effectiveness and practicability of the LiVac®device as well as complications and occurred problems with the device during surgery. The LIVAC retractor is inserted besides an abdominal trocar and uses the vacuum system of the operating room without the need for specific devices. After placement between the left or right liver lobe and the diaphragm, the vacuum is started by minus 0.6 Bar. The liver is retracted without the need of an assistant or extra trocars. After the procedure, the retractor is gently extracted through one of the trocar incisions.
Results: The surgical procedures included liver retraction for various indications including morbidly obese patients (BMI ranging from 28 to 52kg/m2). Reduced Port laparoscopic sleeve gastrectomy and gastric bypass revisions, oncologic gastrectomy with lymphadenectomy, gastrectomy with segmental hepatectomy, and cholecystectomy were successfully performed. In all cases, no problems or difficulties occurred during the application of the retractor. The efficacy of the device was excellent in all cases, and the two sizes of the device (small or large) could be selected depending of the case. There were no device related complications. After extraction of the device, in all cases inspection showed no liver haematoma or bleeding.
Conclusion: The LiVac liver retractor is easy to applicate and provides a good exposure of the operative field in upper gastrointestinal laparoscopic surgery, even in obese patients with a high body mass index.
