Simplified Liver Splitting Technique Using a Curved Chang’s Needle

Abstract

Liver-splitting techniques been previously developed for ex vivo and in situ cadaveric liver transplantation, and more recently for in situ living donor liver transplantation or liver partition with a portal vein ligation for a staged hepatectomy. We report a novel and simplified technique using a long curved needle to make whole-thickness mattress sutures along the division line of the remnant liver above the inferior vena cava to control bleeding, and then bloodlessly splitting the liver with scissors within 40 min in a case of a left lobectomy with metastases from breast cancer. The patient was uneventfully discharged on the fourth postoperative day. When a liver lobectomy or partition to enhance liver regeneration for a staged hepatectomy is necessary, this technique can be done straightforwardly without concern for the problems of venous return or congestion of the recipient or remnant donor liver. This technique is probably the simplest and fastest way for any surgeon and any facility.