Modified hanging maneuver using the goldfinger dissector in laparoscopic right and left hepatectomy.

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. MATERIALS AND 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.