ArticleObesity surgery2025
A Comparative Analysis of the Liver Retraction with Long Surgical Gauze in Three-Port Sleeve Gastrectomy and the Four-Port Nathanson Retractor Technique.
Article in Obesity surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Elastic Intracorporeal Retraction in Laparoscopic Bariatric Surgery: Performance, Safety, and Multi-Organ Applications.Obesity surgery · 2026Article
- Crural stitch technique for liver retraction in laparoscopic upper gastrointestinal surgery: a retrospective case series.BMC surgery · 2025Article
- Assessing the Safety and Aesthetic Benefits of Reduced Port Bikini-Line Sleeve Gastrectomy (RBSG): An Initial Report.Obesity surgery · 2025Article
- Liver Retraction Comparison: Long Gauze in 3-Port vs. Nathanson in 4-Port Sleeve Gastrectomy.Obesity surgery · 2025Article
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Authors and funding
7 authors.
Funding
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Abstract
backgroundThis study evaluated the long surgical gauze (SurG) technique as a liver retraction method in laparoscopic sleeve gastrectomy (LSG). Traditional methods involve the Nathanson retractor, associated with ischemia and necrosis complications. In addition, these techniques require an additional trocar with an incision that increases postoperative pain. Our aim, therefore, was to reduce such complications through the use of SurG and evaluate recovery and outcome implications.
methodsIn this retrospective study, patients who underwent laparoscopic sleeve gastrectomy (LSG) between January and December 2023 were divided into two groups based on the liver retraction method used: NR or SurG. Demographic data, surgery times, postoperative liver enzyme levels (AST, ALT), C-reactive protein (CRP), pain scores, and analgesic use (VAS) were collected from medical records and statistically analyzed.
resultsThe SurG group demonstrated significantly lower postoperative pain scores and reduced analgesic use compared to the NR group (p < 0.001). Additionally, liver enzyme levels (AST, ALT, CRP) were lower in the SurG group, indicating less liver stress. Early mobilization was achieved more quickly in the SurG group, aligning with Enhanced Recovery After Surgery (ERAS) protocols. However, the SurG method showed some limitations during the dissection of the greater curvature due to the narrower field of view.
conclusionsThe long surgical gauze method provides a viable alternative to the Nathanson retractor, offering advantages such as less postoperative pain, reduced liver stress, and quicker mobilization. Despite some technical limitations, this method can improve patient outcomes in sleeve gastrectomy.
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