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Atraumatic Liver Retraction Using Nelaton Catheters During Totally Laparoscopic Gastrectomy

Lee, Si-Hak PhD, MD*,†; Kim, Ki-Hyun MD*; Choi, Cheol Woong PhD, MD; Kim, Su Jin PhD, MD; Kim, Dae-Hwan PhD, MD§; Choi, Chang In PhD, MD§; Jeon, Tae-Yong PhD, MD§; Kim, Dong-Heon PhD, MD§,∥; Hwang, Sun-Hwi PhD, MD*,†

Surgical Laparoscopy, Endoscopy & Percutaneous Techniques: December 2017 - Volume 27 - Issue 6 - p 485–490
doi: 10.1097/SLE.0000000000000489
Original Articles

This study introduces a novel technique for liver retraction during laparoscopic gastrectomy and assesses its impact on postoperative recovery. This study included 139 patients in whom Nelaton catheters (n=57) or Nathanson retractors (n=82) were used for liver retraction. Serum liver enzyme levels were measured preoperatively and on the first, second, third, fifth, and seventh postoperative days. Clinicopathologic features and postoperative recovery variables between the 2 groups were compared. The aspartate aminotransferase, alanine aminotransferase, and C-reactive protein levels were significantly lower (P<0.001, P<0.001, and P=0.007, respectively), and the day of first flatus, the day of initiating a soft diet, and the length of hospital stay were shorter in the Nelaton catheter U-shaped retractor group than those seen in the Nathanson retractor group (P=0.035, P=0.002, and P=0.024, respectively). Atraumatic liver retraction with Nelaton catheters is recommended in laparoscopic gastrectomy.

Departments of *Surgery

Internal medicine

Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan-si, Kyungsangnam-do

§Department of Surgery, School of medicine, Pusan National University

Busan Bohun Hospital, Pusan, Korea

The authors declare no conflicts of interest.

Reprints: Sun-Hwi Hwang, PhD, MD, 20 Geumo-ro, Moolgeum-eup, Yangsan-si, Kyungsangnam-do, Korea (e-mail:

Received April 4, 2017

Accepted August 23, 2017

Copyright © 2017 Wolters Kluwer Health, Inc. All rights reserved.