The “T-Suspension Tape” for Liver and Gallbladder Retraction in Bariatric Surgery: Feasibility, Technique, and Initial Experience

Abstract

The "T-tape suspension" technique is simple, safe, and inexpensive and provides efficient retraction of the liver and gallbladder during bariatric surgery.

Systematic Review of Retraction Devices for Laparoscopic Surgery

“…Shibao et al 13 reported that the field of view was excellent when using the silicone disk, good when using the V-List and Nathanson's retractor, and only fair when using an alternative technique. These results are supported by Zachariah et al, 18 Goel et al, 11 and Schlager et al 12 The magnet-based retractor system, the Endograb, the VaroLift, and the retraction sponge all reported simple operation and a good field of view but with some limitations. The magnetic retractor has limited retraction capability as it only operates with tissue thickness of 1.5 cm or below.…”

“…12,13 The remaining papers analyzed the use and performance of specific devices in particular laparoscopic interventions. 12,[14][15][16][17][18][19][20][21][22] For the cost comparison a total of 13 papers from EMBASE and 62 from MEDLINE were retrieved. Only 15 fitted the criteria and were selected for further review.…”

Intra-abdominal Trocar-Free Vacuum Liver Retractor for Upper-Gastrointestinal Surgery

“…13,14 Similarly, the T-suspension tape is another totally internal liver retraction technique using the Tevlon tail of a Jackson Pratt drain that is slung around the liver and sutured to the abdominal wall. Zachariah et al 15 reported a mean time of 4.5 minutes to place the retractor; there were no complications, and the technique provided good visualization and working space. Other authors have described methods where the liver is sutured directly to the abdominal wall using a monofilament suture.…”

Novel Trocar-Free Elastic Liver Retractor in Bariatric Surgery Patients: Comparison of a Standard Laparoscopic Retraction With the First Series Using the LiVac Sling System

“…Similarly, the T-suspension tape is another internal liver retraction technique. 15 The tape was created using the Teflon (DuPont, Wilmington, DE) tail of a Jackson-Pratt drain secured to a Prolene (Ethicon, Blue Ash, OH) suture on a long straight needle. In this case, the liver is retracted by a transparenchymal passage of the needle, which is exteriorized and secured to the anterior abdominal wall.…”