Comparative analysis of different methods of retraction of the left lobe of the liver during laparoscopic sleeve gastrectomy

The global obesity epidemic has led to the increasing popularity of bariatric surgeries. Laparoscopic sleeve gastrectomy is currently the most popular bariatric procedure for obesity. Retracting of the left liver lobe during laparoscopic sleeve gastrectomy is important for achieving an optimal surgi...

Full description

Saved in:
Bibliographic Details
Main Authors: O. O. Kalashnikov, O. Yu. Usenko, I. M. Todurov, S. V. Kosiukhno
Format: Article
Language:English
Published: Zaporizhzhia State Medical and Pharmaceutical University 2023-09-01
Series:Сучасні медичні технології
Subjects:
Online Access:https://zmapo-journal.com/index.php/journal/article/view/276
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1850087579818393600
author O. O. Kalashnikov
O. Yu. Usenko
I. M. Todurov
S. V. Kosiukhno
author_facet O. O. Kalashnikov
O. Yu. Usenko
I. M. Todurov
S. V. Kosiukhno
author_sort O. O. Kalashnikov
collection DOAJ
description The global obesity epidemic has led to the increasing popularity of bariatric surgeries. Laparoscopic sleeve gastrectomy is currently the most popular bariatric procedure for obesity. Retracting of the left liver lobe during laparoscopic sleeve gastrectomy is important for achieving an optimal surgical field. Aim. The aim of our study was to evaluate the results of using different methods of retraction of the left liver lobe during laparoscopic sleeve gastrectomy in patients with morbid obesity. Materials and methods. The 86 patients who underwent laparoscopic sleeve gastrectomy were divided into three groups based on the liver retraction method used: group 1 (ENDO RETRACT™ II), group 2 (Nathanson) and group 3 (Clickline Surgical Sponge Holder). All groups were evaluated in terms of demographic characteristics; liver function tests just before surgery and on the 1st and 2nd postoperative day (POD); developing complications and length of hospital stay. Results. The groups did not differ significantly in terms of demographic characteristics (p > 0.05). The Nathanson liver retractor (group 2) caused a significant rise in ALT and AST at POD 1 and POD 2 compared with group 1 and 3 (p < 0.05). The ENDO RETRACT™ II liver retractor (group 1) caused a higher incidence of liver injury than other groups. It led to statistical significance prolonged total operation time (p = 0.003), increased blood loss (p = 0.002) and prolonged postoperative hospital stay (p = 0.001) compared with other groups. Conclusions. The technique of left lobe retraction during laparoscopic sleeve gastrectomy using Clickline Sur- gical Sponge Holder is safe and effective. The use of this technique causes significantly less measurable liver damage and does not lead to an increase in the level of liver enzymes.
format Article
id doaj-art-5efec6e1e01545b2b3dd17269f1cde26
institution DOAJ
issn 2072-9367
language English
publishDate 2023-09-01
publisher Zaporizhzhia State Medical and Pharmaceutical University
record_format Article
series Сучасні медичні технології
spelling doaj-art-5efec6e1e01545b2b3dd17269f1cde262025-08-20T02:43:12ZengZaporizhzhia State Medical and Pharmaceutical UniversityСучасні медичні технології2072-93672023-09-01351110.34287/MMT.3(58).2023.1276Comparative analysis of different methods of retraction of the left lobe of the liver during laparoscopic sleeve gastrectomyO. O. Kalashnikov0O. Yu. Usenko1I. M. Todurov2S. V. Kosiukhno3State Scientific Institution “Center for Innovative Medical Technologies of the National Academy of Sciences of Ukraine”, KyivState Institute “Shalimov’s National Institute of Surgery and Transplantation” of the National Academy of Medical Sciences of Ukraine, KyivState Scientific Institution “Center for Innovative Medical Technologies of the National Academy of Sciences of Ukraine”, KyivState Scientific Institution “Center for Innovative Medical Technologies of the National Academy of Sciences of Ukraine”, KyivThe global obesity epidemic has led to the increasing popularity of bariatric surgeries. Laparoscopic sleeve gastrectomy is currently the most popular bariatric procedure for obesity. Retracting of the left liver lobe during laparoscopic sleeve gastrectomy is important for achieving an optimal surgical field. Aim. The aim of our study was to evaluate the results of using different methods of retraction of the left liver lobe during laparoscopic sleeve gastrectomy in patients with morbid obesity. Materials and methods. The 86 patients who underwent laparoscopic sleeve gastrectomy were divided into three groups based on the liver retraction method used: group 1 (ENDO RETRACT™ II), group 2 (Nathanson) and group 3 (Clickline Surgical Sponge Holder). All groups were evaluated in terms of demographic characteristics; liver function tests just before surgery and on the 1st and 2nd postoperative day (POD); developing complications and length of hospital stay. Results. The groups did not differ significantly in terms of demographic characteristics (p > 0.05). The Nathanson liver retractor (group 2) caused a significant rise in ALT and AST at POD 1 and POD 2 compared with group 1 and 3 (p < 0.05). The ENDO RETRACT™ II liver retractor (group 1) caused a higher incidence of liver injury than other groups. It led to statistical significance prolonged total operation time (p = 0.003), increased blood loss (p = 0.002) and prolonged postoperative hospital stay (p = 0.001) compared with other groups. Conclusions. The technique of left lobe retraction during laparoscopic sleeve gastrectomy using Clickline Sur- gical Sponge Holder is safe and effective. The use of this technique causes significantly less measurable liver damage and does not lead to an increase in the level of liver enzymes.https://zmapo-journal.com/index.php/journal/article/view/276obesitygastrectomylaparoscopyliver retractionliver dysfunctionliver injury
spellingShingle O. O. Kalashnikov
O. Yu. Usenko
I. M. Todurov
S. V. Kosiukhno
Comparative analysis of different methods of retraction of the left lobe of the liver during laparoscopic sleeve gastrectomy
Сучасні медичні технології
obesity
gastrectomy
laparoscopy
liver retraction
liver dysfunction
liver injury
title Comparative analysis of different methods of retraction of the left lobe of the liver during laparoscopic sleeve gastrectomy
title_full Comparative analysis of different methods of retraction of the left lobe of the liver during laparoscopic sleeve gastrectomy
title_fullStr Comparative analysis of different methods of retraction of the left lobe of the liver during laparoscopic sleeve gastrectomy
title_full_unstemmed Comparative analysis of different methods of retraction of the left lobe of the liver during laparoscopic sleeve gastrectomy
title_short Comparative analysis of different methods of retraction of the left lobe of the liver during laparoscopic sleeve gastrectomy
title_sort comparative analysis of different methods of retraction of the left lobe of the liver during laparoscopic sleeve gastrectomy
topic obesity
gastrectomy
laparoscopy
liver retraction
liver dysfunction
liver injury
url https://zmapo-journal.com/index.php/journal/article/view/276
work_keys_str_mv AT ookalashnikov comparativeanalysisofdifferentmethodsofretractionoftheleftlobeoftheliverduringlaparoscopicsleevegastrectomy
AT oyuusenko comparativeanalysisofdifferentmethodsofretractionoftheleftlobeoftheliverduringlaparoscopicsleevegastrectomy
AT imtodurov comparativeanalysisofdifferentmethodsofretractionoftheleftlobeoftheliverduringlaparoscopicsleevegastrectomy
AT svkosiukhno comparativeanalysisofdifferentmethodsofretractionoftheleftlobeoftheliverduringlaparoscopicsleevegastrectomy