Abstract
Background
The availability of videos of different procedures is certainly contributing to the diffusion and standardization of surgical procedures around the world. This didactical video article shows step-by-step a “counterclockwise” technique which we have previously described for liver procurement whenever the pancreas is not procured.
Methods
The technique entails 6 steps: the hepatic pedicle, the pancreatic neck, the superior mesenteric artery (SMA), the celiac trunk, the supraceliac aorta, and the inferior vena cava. This technique follows a “counterclockwise” sequence around the liver.
Results
The routine practice with this technique at our unit showed high reproducibility while maintaining the safety of the procedure among different young fellows trained over the years. The limits of this technique are represented by the fact that is reserved to cases without pancreas procurement.
Conclusions
The “counterclockwise” technique represents a valid and an easy technique to learn for liver procurement.
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References
Addeo P, Souche R, Bachellier P (2015) An alternative technique for harvesting marginal liver grafts with a replaced or accessory right hepatic artery. World J Surg 39:1828–1831
Starzl TE, Hakala TR, Shaw BW Jr et al (1984) A flexible procedure for multiple cadaveric organ procurement. Surg Gynecol Obstet 158:223–230
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Lebreton G, Chiche L (2002) Organ harvesting: (1) liver. J Chir (Paris) 139(6):343–347
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Substantial contributions to the conception or design of the work: PA, OJ, PB; acquisition, analysis, or interpretation of data for the work: PA, OJ, PB; drafting the work or revising it critically for important intellectual content: PA, OJ, PB; Final approval of the version to be published: PA, OJ, PB; Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work is appropriately investigated and resolved: PA, OJ, PB
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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
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Addeo, P., Julliard, O. & Bachellier, P. Liver procurement: the counterclockwise technique step-by-step with video. Langenbecks Arch Surg 406, 935–936 (2021). https://doi.org/10.1007/s00423-020-02074-9
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DOI: https://doi.org/10.1007/s00423-020-02074-9