الفهرس 
Portless liver retraction in laparoscopic surgery
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Abstract
Background: The main aspect of concern for upper GI procedures has been the retraction of the liver especially large left lobes as commonly encountered in Bariatric surgery. Not doing so would compromise the view of the hiatus, hence theoretically reducing the quality of the surgery and increasing the possibility of complications. Methods: Case series study including 20 patients who were admitted to Cairo University Hospitals and underwent laparoscopic bariatric surgery. The outcome of the procedure was evaluated in terms of safety, operative time and grade of exposure of the hiatus. Results: The mean operative time needed for liver retraction was around 7 minutes. Only one case had a small liver tear resulting from the grasper used for division of the left triangular ligament which didn{u2019}t need any intervention. Exposure of the surgical field achieved by this technique was comparable or better than the usual exposure we achieve using standard retractors. Conclusion: The umbilical tape sling method achieved effective liver retraction , cosmetically better , without clinically significant trauma. It allowed appropriate exposure of the operative field and without significant increase in operative time in laparoscopic upper abdominal surgery