• S Wu, H Yu, Y Fan, J Kong, and X Yu.
• Second Department of General Surgery, Shengjing Hospital of China Medical University, 36 Sanhao Street, Heping District, Shenyang City, 110004, Liaoning Province, China.
• Br J Surg. 2014 Apr 1; 101 (5): 546-9.

BackgroundLiver retraction is critical in single-incision laparoscopic upper abdominal surgery. Several techniques have been reported. Some need an additional port, whereas others are complicated and time-consuming.Methodsn-Butyl-2-cyanoacrylate (NBCA) glue was applied to bond the left lateral lobe of the liver to the diaphragm in different single-incision laparoscopic upper abdominal procedures. Liver adhesion time and duration of operation were recorded, and preoperative and postoperative liver function tests carried out.ResultsAll procedures were completed successfully without additional ports or special instruments. The technique provided adequate workspace and a clear view. Mean liver adhesion time was 1·5 min. The maximum operating time was 310 min. Levels of alanine and aspartate aminotransferases were raised on day 1 after surgery but had returned to normal by day 7.ConclusionCreating adhesion between the left lateral lobe of the liver and the diaphragm using NBCA glue is a simple, safe and effective way of achieving liver retraction in single-incision laparoscopic upper abdominal surgery.© 2014 BJS Society Ltd. Published by John Wiley & Sons Ltd.

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