title: Liver hanging maneuver: an anatomic and clinical review.
abstract: BACKGROUND
  Liver hanging maneuver (LHM) allows to hang the liver during right hepatectomies without primary liver mobilization. The avascular plane used in this technique has been poorly described in the anatomical literature, and intraoperative bleeding because of hepatic vein injuries has been reported.
  
  
  METHODS
  Major clinical and anatomic articles focusing on the retrohepatic portion of the inferior vena cava (IVC) and the LHM were reviewed.
  
  
  CONCLUSIONS
  LHM is as an effective and safe method of guiding hepatic transection to the IVC during right hepatectomies with a feasibility rate up to 95% and minor bleeding in 0% to 6% of cases. According to small series and experts' opinions, LHM would improve parenchymal transection by reducing operative time and blood loss. The tape would ensure a linearly cut surface with IVC safer protection, better exposure, and hemostasis of the deeper plane. Limited remnant liver mobilization could reduce the risk for malignant dissemination and improve liver function. Hepatectomies for huge tumor with diaphragm adhesions could be facilitated.
authors: Paris V Faculty of Medicine, Paris Institute of Anatomy, 45, rue des Saints-Pères, 75006 Paris, France.
authors: Sébastien
authors: S
authors: Gaujoux
authors: Richard
authors: R
authors: Douard
authors: Giuseppe Maria
authors: GM
authors: Ettorre
authors: Vincent
authors: V
authors: Delmas
authors: Jean-Marc
authors: JM
authors: Chevallier
authors: Paul-Henri
authors: PH
authors: Cugnenc
mesh_terms: D004210:Dissection; D006498:Hepatectomy / Q000379:methods*; D006503:Hepatic Veins / Q000293:injuries; D006801:Humans; D008099:Liver / Q000033:anatomy & histology* / Q000098:blood supply / Q000601:surgery; D008340:Mandibular Nerve