MODIFIED HANGING MANEUVER USING THE GOLDFINGER© DISSECTOR IN LAPAROSCOPIC RIGHT AND LEFT HEPATECTOMY

The liver-hanging maneuver is a useful technique to transect the liver parenchyma in open approach while lifting it with a tape passed between the anterior surface of the inferior vena cava and the liver parenchyma. Due to the specific issue of the technique, the hanging maneuver during laparoscopic liver resection (LLR) is not routinely utilized. We describe the technique and results of our experience on a modified hanging maneuver in 13 right and 5 left hepatectomies. This modified hanging maneuver technique is based on the use of the “Goldfinger©” dissector in several steps: a) for the upper dissection of the space between right and middle hepatic veins, b) to create the infero-superior arcade through the space between the anterior surface of the vena cava and the posterior surface of the liver, c) to lift the cutting area of the liver from the posterior to the anterior direction during LLR, d) to indicate the parenchymal transection line. The modified hanging maneuver for laparoscopic right and left hepatectomy based on the use of Goldfinger is safe, efficient, reproducible, and can facilitate liver dissection during major hepatectomy.