title: Modified hanging maneuver using the goldfinger dissector in laparoscopic right and left hepatectomy.
abstract: BACKGROUND
  The liver hanging maneuver is a useful technique to transect the liver parenchyma in an open approach while lifting it with a tape passed between the anterior surface of the inferior vena cava and the liver parenchyma. The hanging maneuver during laparoscopic liver resection is not routinely utilized.
  
  
  METHODS
  We describe the technique and results of a modified hanging maneuver using the Goldfinger dissector in 13 right and 5 left hepatectomies. This technique allowed us to dissect the space between right and middle hepatic veins; to create the infero-superior arcade through the space between the anterior surface of the vena cava and the posterior surface of the liver; to lift the cutting area of the liver from the posterior to the anterior direction; to indicate the parenchymal transection line.
  
  
  RESULTS
  The median resection time and blood loss were 96 min and 220 ml respectively. No conversion was recorded. Two complications (11%) occurred: a biliary fistula and a respiratory distress syndrome, spontaneously resolved.
  
  
  CONCLUSIONS
  The modified hanging maneuver for laparoscopic right and left hepatectomy based on the use of the Goldfinger dissector is safe, reproducible, and can facilitate liver dissection during major hepatectomy.
authors.affiliation: Department of General and Hepato-Biliary Surgery, Liver Transplantation Service, Ghent University Hospital and Medical School, Ghent, Belgium. roberto.troisi@ugent.be
authors.forename: Roberto I
authors.initials: RI
authors.lastname: Troisi
authors.forename: Roberto
authors.initials: R
authors.lastname: Montalti
mesh_terms: D000328:Adult; D000368:Aged; D004210:Dissection / Q000295:instrumentation* / Q000379:methods; D005240:Feasibility Studies; D005260:Female; D006498:Hepatectomy / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000295:instrumentation / Q000379:methods*; D008113:Liver Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome