Liver Retraction Techniques in Laparoscopic Gastric Surgery
Summary
Liver retraction is a pivotal step in laparoscopic gastric procedures, affording optimal exposure of the oesophagogastric junction and proximal stomach while safeguarding hepatic perfusion. Traditional approaches employ a rigid metallic retractor positioned beneath the left lobe, but such methods carry a risk of localised pressure injury and transient elevation of hepatocellular enzymes. Innovations include the addition of a silicone or polymeric disk on the retractor blade to disperse compressive forces, periodic repositioning to limit cumulative compression time and the use of flexible suspension devices—such as Penrose drains or intracorporeal sutures—that conform to the liver surface. Robotic platforms permit multi-arm retraction with dynamic adjustment, reducing reliance on fixed ports. Preoperative three-dimensional imaging of hepatic and perigastric vasculature further informs retraction strategy, allowing avoidance of aberrant arteries and minimising intraoperative bleeding. Taken together, these advances seek to balance adequate surgical exposure with preservation of liver function, thereby supporting rapid postoperative recovery and broad applicability across patient populations.
Research from Nature Portfolio
No recent Nature Portfolio content available.
Liver Retraction Techniques in Laparoscopic Gastric Surgery publication trend
The graph below shows the total number of articles in liver retraction techniques in laparoscopic gastric surgery across all publications each year (not limited to Nature Index journals).
Technical terms
Nathanson liver retractor: A curved metallic instrument introduced through an epigastric port that hooks under the left hepatic lobe to lift it away from the operative field.
Postoperative transient liver dysfunction (POTLD): A reversible hepatocellular injury after surgery, manifested by temporary elevation of liver enzymes without lasting impairment of hepatic function.
Duplicate left gastric artery: A rare vascular variant in which two distinct arteries supply the stomach, one arising from the splenic artery and the other from the coeliac trunk, necessitating bespoke retraction planning.
References
- Novel use of the Nathanson liver retractor to prevent postoperative transient liver dysfunction during laparoscopic gastrectomy. Asian Journal of Endoscopic Surgery (2019).
- Study on the application of preoperative three-dimensional CT angiography of perigastric arteries in laparoscopic radical gastrectomy. Scientific Reports (2022).
- Duplicate left gastric artery identified during robot-assisted distal gastrectomy: a case report. Surgical Case Reports (2023).
About these summaries
This Nature Research Intelligence Topic summary is created with the cited references and a large language model. We take care to ground generated text with facts, and have systems in place to gain human feedback on the overall quality of the process in line with our AI principles. We strive to create accurate and useful summaries for people unfamiliar with the research topic and that supports this goal. These pages are a beta release and will be updated as we learn how best to help people gain value from a research topic summary.
Turn complex research questions into confident strategic decisions
When you're under pressure to set direction, justify investment, or understand your competitive position, you need more than raw data — you need trusted insights you can act on.
Benchmark your performance against global peers using robust, methodologically sound analysis.
Combine quantitative metrics with qualitative expert insight to uncover strengths, gaps and emerging opportunities.
Gain tailored, decision-ready recommendations aligned to your strategic priorities.
Talk to us to learn more about our data dashboards and bespoke strategy reports.
Grow research skills, confidence and careers with training built for every stage of the research lifecycle.
Developed with Nature Portfolio journal Editors and internationally renowned experts. Discover three ways to learn:
Self-paced, online courses in convenient bite-sized units, covering key skills across scientific writing, publishing, grant writing, data analysis, and more.
Expert trainer-led workshops with hands-on exercises and real-time feedback across core research skills, delivered via interactive group sessions.
Editor-led workshops combining core principles in writing and publishing, personalised 1:1 feedback from Nature Portfolio Editors and hands-on exercises.
Explore course catalogues and workshop agendas, enquire about the options or request institutional pricing.