The pediatric surgeon's perspective on the liver hanging maneuver: a case report and literature review

IntroductionThe liver hanging maneuver (HM) is a well–established technique in hepatic surgery, primarily employed to optimize exposure and simplify parenchymal transection during liver resections. While its efficacy and safety have been extensively documented in adult populations, reports on its ap...

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Main Authors: Francesca Gigola, Kejd Bici, Antonino Morabito, Chiara Grimaldi
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-03-01
Series:Frontiers in Pediatrics
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Online Access:https://www.frontiersin.org/articles/10.3389/fped.2025.1536755/full
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author Francesca Gigola
Kejd Bici
Antonino Morabito
Antonino Morabito
Chiara Grimaldi
author_facet Francesca Gigola
Kejd Bici
Antonino Morabito
Antonino Morabito
Chiara Grimaldi
author_sort Francesca Gigola
collection DOAJ
description IntroductionThe liver hanging maneuver (HM) is a well–established technique in hepatic surgery, primarily employed to optimize exposure and simplify parenchymal transection during liver resections. While its efficacy and safety have been extensively documented in adult populations, reports on its application in pediatric surgery are limited. This may be related to peculiarities of the liver anatomy and texture in children and to some specific issues of pediatric liver tumors, especially hepatoblastoma (HB).MethodsThis study reviews the technical adaptations, feasibility, and outcomes of the HM in children, focusing on its role in both routine liver resections and complex cases, such as the separation of conjoined twins. Data of patients treated with and without HM at our center were retrospectively analyzed and a review of recent literature on this topic was performed.ResultsA total of 16 pediatric patients (7 females) underwent HM during hepatic resections with a median age at surgery of 16 months (IQR: 8–22.5). No complications or mortality related to surgery were observed.DiscussionResults demonstrate that with appropriate modifications, the HM is a safe and effective technique in children, offering advantages in minimizing bleeding while improving surgical efficiency.
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spelling doaj-art-d979c9d15a7b49f5b26e476785c66d652025-08-20T02:59:28ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602025-03-011310.3389/fped.2025.15367551536755The pediatric surgeon's perspective on the liver hanging maneuver: a case report and literature reviewFrancesca Gigola0Kejd Bici1Antonino Morabito2Antonino Morabito3Chiara Grimaldi4School of Pediatric Surgery, University of Florence, Florence, ItalyDiagnostic and Therapeutic Services Department, IRCCS-ISMETT (Mediterranean Institute for Transplantation and Advanced Specialized Therapies), Palermo, ItalyDepartment of Pediatric Surgery, Meyer Children’s Hospital IRCCS, Florence, ItalyDepartment of Neuroscience, Psychology, Drug Research and Child Health (NEUROFARBA), University of Florence, Florence, ItalyDepartment of Pediatric Surgery, Meyer Children’s Hospital IRCCS, Florence, ItalyIntroductionThe liver hanging maneuver (HM) is a well–established technique in hepatic surgery, primarily employed to optimize exposure and simplify parenchymal transection during liver resections. While its efficacy and safety have been extensively documented in adult populations, reports on its application in pediatric surgery are limited. This may be related to peculiarities of the liver anatomy and texture in children and to some specific issues of pediatric liver tumors, especially hepatoblastoma (HB).MethodsThis study reviews the technical adaptations, feasibility, and outcomes of the HM in children, focusing on its role in both routine liver resections and complex cases, such as the separation of conjoined twins. Data of patients treated with and without HM at our center were retrospectively analyzed and a review of recent literature on this topic was performed.ResultsA total of 16 pediatric patients (7 females) underwent HM during hepatic resections with a median age at surgery of 16 months (IQR: 8–22.5). No complications or mortality related to surgery were observed.DiscussionResults demonstrate that with appropriate modifications, the HM is a safe and effective technique in children, offering advantages in minimizing bleeding while improving surgical efficiency.https://www.frontiersin.org/articles/10.3389/fped.2025.1536755/fullliver hanging maneuverchildrenhepatoblastomahepatectomyliver resection
spellingShingle Francesca Gigola
Kejd Bici
Antonino Morabito
Antonino Morabito
Chiara Grimaldi
The pediatric surgeon's perspective on the liver hanging maneuver: a case report and literature review
Frontiers in Pediatrics
liver hanging maneuver
children
hepatoblastoma
hepatectomy
liver resection
title The pediatric surgeon's perspective on the liver hanging maneuver: a case report and literature review
title_full The pediatric surgeon's perspective on the liver hanging maneuver: a case report and literature review
title_fullStr The pediatric surgeon's perspective on the liver hanging maneuver: a case report and literature review
title_full_unstemmed The pediatric surgeon's perspective on the liver hanging maneuver: a case report and literature review
title_short The pediatric surgeon's perspective on the liver hanging maneuver: a case report and literature review
title_sort pediatric surgeon s perspective on the liver hanging maneuver a case report and literature review
topic liver hanging maneuver
children
hepatoblastoma
hepatectomy
liver resection
url https://www.frontiersin.org/articles/10.3389/fped.2025.1536755/full
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