Exposure for hepatic surgery in the obese patient: an innovative adaptation in time of need…

Abstract

Obesity has become a major public health concern. More and more patients with substantial obesity require surgery including complex hepatobiliary interventions. The morphology of these patients can make surgery difficult, especially in terms of exposure. We report the case of an obese patient who required a left hemihepatectomy for colorectal liver metastasis. It was very difficult to obtain adequate exposure; this problem was solved by transcutaneous introduction of the handle of a broad costal margin retractor. We describe this maneuver, which allowed us to carry out the intervention under excellent conditions.