Liver retraction near the esophagogastric junction during bariatric surgery is necessary to provide the surgeon with a clear view of the operative site. The use of conventional retraction requires an additional incision, which leads to a scar and pain.We used 3 pieces of 3-mm Lone Star Elastic elastic stays with sharp hooks (Cooper Surgical, Trumbull, CT) and 2 pieces of 2-0 Ti-Cron Sutures (Syneture, Covidien, Mansfield, MA) to tie 3 of the elastic stays in a bundle. Before the elastic stays were tied, they were shortened 2 inches from their original length, and special attention was paid to make the sharp ends of the elastic stays face each other. The initial knot was tied 1 inch away from the shortened ends of the hooks, and the latter knot was tied one-quarter inch away from the first knot. The retractor was then placed into the abdomen via a 12-mm trocar. Retraction was accomplished by placing hooks into the left crus of the diaphragm and the anterior abdominal wall, both to the right and to the left of the falciform ligament.We performed a Roux-en-Y gastric bypass using this technique. We had an adequate view of the esophageal hiatus with no additional retraction needed. Removing the retractor required attention to the hooks to avoid catching tissue or the edge of the trocar.Compared with conventional liver retraction, this method is more surgeon dependent, because the angle between the stays plays a critical role in the device’s ability to perform adequate retraction. A special texture on the elastic stays may prevent any sliding of the liver and make this retractor a better instrument for a broader range of patients.This technique may have potential for use in single incision laparoscopic surgery. (Video).DisclosureThe authors have no commercial associations that might be a conflict of interest in relation to this article. Liver retraction near the esophagogastric junction during bariatric surgery is necessary to provide the surgeon with a clear view of the operative site. The use of conventional retraction requires an additional incision, which leads to a scar and pain. We used 3 pieces of 3-mm Lone Star Elastic elastic stays with sharp hooks (Cooper Surgical, Trumbull, CT) and 2 pieces of 2-0 Ti-Cron Sutures (Syneture, Covidien, Mansfield, MA) to tie 3 of the elastic stays in a bundle. Before the elastic stays were tied, they were shortened 2 inches from their original length, and special attention was paid to make the sharp ends of the elastic stays face each other. The initial knot was tied 1 inch away from the shortened ends of the hooks, and the latter knot was tied one-quarter inch away from the first knot. The retractor was then placed into the abdomen via a 12-mm trocar. Retraction was accomplished by placing hooks into the left crus of the diaphragm and the anterior abdominal wall, both to the right and to the left of the falciform ligament. We performed a Roux-en-Y gastric bypass using this technique. We had an adequate view of the esophageal hiatus with no additional retraction needed. Removing the retractor required attention to the hooks to avoid catching tissue or the edge of the trocar. Compared with conventional liver retraction, this method is more surgeon dependent, because the angle between the stays plays a critical role in the device’s ability to perform adequate retraction. A special texture on the elastic stays may prevent any sliding of the liver and make this retractor a better instrument for a broader range of patients. This technique may have potential for use in single incision laparoscopic surgery. (Video). DisclosureThe authors have no commercial associations that might be a conflict of interest in relation to this article. The authors have no commercial associations that might be a conflict of interest in relation to this article. AppendixSupporting Information Download .mov (16.55 MB) Help with mov files Supplementary Video Supporting Information Download .mov (16.55 MB) Help with mov files Supplementary Video Download .mov (16.55 MB) Help with mov files Supplementary Video