What Is a Liver Retractor?

A liver retractor is a surgical instrument used to move the liver out of the visual field of the surgeon during an operation involving the abdominal cavity. It may also be used to provide support for the liver as it is moved from its original location. Most liver retractors are designed to be used multiple times and must be sterilized prior to being used in the surgical procedure. The size and shape of a liver retractor depends on the type of operation being performed, such as an endoscopic, laparoscopic, or open abdominal surgery. Generally, at least three sizes of retractors will be prepared for each type of procedure, allowing the surgeon to choose the best size for the patient.

One type of retractor is called a triangular liver retractor. The thin metal tubing forms a triangle-like opening at the end of the instrument. Once this retractor is inserted into the abdominal cavity, it can be used to lift the organ, or move other internal structures away from the visual field of the surgeon. This type of retractor is used most often during endoscopic operations.

Another liver retractor used in endoscopic procedures is called a Nathanson® retractor. This instrument features long thin tubing with a slightly horseshoe shaped end. The curved end is used to hold the liver in place while the surgeon completes the procedure.

A liver retractor used for laparoscopic procedures has two angles separated by thin tubing. The upper angle allows for the insertion of the instrument into the abdominal cavity, and the lower rounded angle is used to hold and move the liver and other abdominal organs as needed. This type of retractor is most commonly used during a gastric bypass surgery.

Open abdominal surgeries may require the use of a large liver retractor that is mounted to a table for stability. The device has four legs connected to the curved portion of the retractor that holds the organ in position. It may be left in place throughout an extended operation.

Complications from using a liver retractor during surgery are varied. The additional incision necessary to insert the retractor may become infected and require treatment with antibiotics. Occasionally, a laceration or cut may occur on the surface of the liver that can cause longer healing times and an increase in the pain and discomfort reported by the patient. Rarely, the lobe of the liver that was retracted during the endoscopic or laparoscopic operations may develop venous congestion that results in a lack of oxygenated blood circulating throughout the hepatic system. The decrease in oxygen may cause necrosis to develop in the lobe of the liver that was moved during the operation, and cause a need for a further surgery to remove the affected lobe.