Rubber tourniquet technique: A simple, safe, and cost-effective method of hepatic resection in neonates and infants

Abstract

BackgroundDespite the improvements in patient care, understanding of surgical anatomy of liver and surgical techniques, liver resection is a high-risk procedure specifically in infants and neonates; whose blood volume is limited (80 ml/kg). This report shares the experience of hepatic resection with “Rubber tourniquet technique” in patients less than 6-months of age. MethodsHepatic resection in a 4-month-old pair of Conjoined twins with shared liver and a 3-day old baby with large Congenital Hepatoblastoma was performed using Penrose rubber drain as a tourniquet around the liver parenchyma to reduce blood loss. ResultsBlood loss was minimal (<20CC) and all the three babies survived the procedure without complications. ConclusionRubber tourniquet technique is simple, safe and cost-effective for liver resections in neonates and infants with hepatic lesions and separation of conjoined twins with shared liver and it can easily be employed in resource constraint settings.