Convenience of a tape-guiding technique in different types of hepatectomy.
OBJECTIVE
The liver hanging maneuver is widely used in right lobectomy to resect huge tumors and harvest living donors. The convenience of tape assistance in other types of hepatectomy is not well known.


METHODS
Tape-guiding technique (TGT) was applied in 30 hepatectomies of different type between April 2003 and April 2006. The indications were liver carcinoma in 22 and living-donor in 8. Hepatectomies included right lobectomy, 14; left lobectomy with caudate lobectomy, 8; left lobectomy without caudate lobectomy, 2; lateral segmentectomy, 3; central bisegmentectomy, posterior segmentectomy, and superior dorsal partial resection, 1 each. A tape was placed in front of the inferior vena cava for right hepatectomy and left hepatectomy with caudate lobectomy. In other hepatectomies, the tape was positioned to be the target of parenchymal dissection.


RESULTS
TGT was successfully performed in all 30 cases. Tape facilitated dissection by helping the surgeon maintain orientation, and traction on the tape flattened the parenchyma, making it easier to identify and manage vessels and ducts. With an assistant holding the tape, the surgeon's left hand was free, and ligation and suturing was easier and more secure.


CONCLUSIONS
The TGT is a convenient technique that is applicable to different types of liver resection.
Hepato-Biliary-Pancreatic Surgery, Osaka City University Graduate School of Medicine, Abeno-ku, Osaka 545-8585, Japan. tanakahm@msic.med.osaka-cu.ac.jp
Hiromu
H
Tanaka
Shigekazu
S
Takemura
Kazuki
K
Ohba
Seikan
S
Hai
Tsuyoshi
T
Ichikawa
Shintaro
S
Kodai
Hiroji
H
Shinkawa
Taichi
T
Shuto
Kazuhiro
K
Hirohashi
Shoji
S
Kubo
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical / Q000517:prevention & control; D004210:Dissection; D005260:Female; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D008113:Liver Neoplasms / Q000601:surgery; D016031:Liver Transplantation; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D020858:Tissue and Organ Harvesting