To introduce a modified liver retraction technique using a hernia needle grasper with a latex tube during laparoscopic bariatric surgery and evaluate its safety and effectiveness.

A retrospective study was conducted on the clinical data of 60 obese patients who underwent laparoscopic sleeve gastrectomy in Affiliated Hospital of Nantong University from October 2021 to June 2023. All cases were divided into two groups based on whether this method was used during the surgery: the study group (n=20) and the control group (n=40). In the study group, a hernia needle grasper with a latex tube was used to retract the liver, and the redundant part of the latex tube extending leftward had enough strength to push aside the residue omentum. In the control group, an additional trocar was made so the assistant could use a lobulated liver retractor to retract the liver. Clinical data such as changes in liver enzyme levels, the operating time, postoperative C-reactive protein (CRP), postoperative hospital stay, and complications were compared between the two groups.

All surgeries were completed without conversion. The study group achieved adequate exposure, and it took (160.2±37.6) seconds to finish the liver retracting technique. By comparing the changes in liver enzymes (ALT, AST) and postoperative CRP levels between the two groups, no significant liver function damage was found to be caused by the use of this liver retraction technique. The incidence of related complications such as subcapsular liver hematoma or liver laceration was 0/20 (0.0%) and 3/40 (7.5%) in the study and control groups. No significant differences were observed in operating time or postoperative hospital stay between the groups.

Using a hernia needle grasper with a latex tube for liver retraction while pushing aside the residue omentum is safe and effective. It is suitable for three-port or single-port laparoscopic sleeve gastrectomy and can be applied to other laparoscopic bariatric surgery.