Cantilever liver retraction devices and methods of use

A method of lifting the liver of a patient, the patient having an abdomen, an abdominal wall having an inner surface, and a diaphragm, said method comprising:

• providing an intra-abdominal liver retraction device comprising a generally J or L shaped body, a stabilizing member, and a lifting or elevating filament, said generally J or L shaped body including an elongated section, an intermediate section, and a foot section, said elongated section having a proximal end, said foot section extending at an angle to said elongated section, said stabilizing member having a pair of ends disposed opposite each other and being coupled to said proximal end and configured to be moved with respect thereto from a first orientation to a second orientation and vice versa, said stabilizing member when in said first orientation extending generally perpendicular to said elongated section, said stabilizing member when in second orientation extending generally parallel to said elongated section, said flexible filament being connected to said elongated section;
• introducing said intra-abdominal liver retraction device with said stabilizing member orientated in said second orientation through a port in the abdominal wall into the abdomen;
• causing said stabilizing member to be oriented in said first orientation when said intra-abdominal liver retraction device is within the abdomen;
• causing said foot section to be brought to a position adjacent a portion of the diaphragm and with a portion of said elongated section being disposed under the liver and with at least a portion of said foot section disposed under the liver;
• and
• drawing said flexible filament through an aperture in the abdominal wall from outside the abdomen to bring said stabilizing member into frictional engagement with a portion of the inner surface of the abdominal wall and to cause said elongated section and said foot section to lift the liver upward towards the abdominal wall.

An intra-abdominal liver retraction device for use in a patient, the patient having a liver, an abdomen, an abdominal wall and a diaphragm, said intra-abdominal liver retraction device being configured to be introduced into the abdomen via an instrument port extending through the abdominal wall during an insertion mode of operation, said intra-abdominal liver retraction device comprising:

• a first section and a second section secured together at a first pivotable joint, said first section configured to be flexed into a generally linear elongated shape during an insertion mode of operation, said first section having a distal end and a proximal end, said second section having a generally linear elongated shape;
• a third section having a generally linear shape and being pivotably connected to said second section by a second pivotable joint, whereupon said third section extends parallel to said second section, said second pivotable joint being releasable, said second and said third sections being configured to extend parallel to each other and substantially collinearly with said first section during said insertion mode of operation;
• and
• a flexible filament having a distal end portion, an intermediate portion, and a proximal end portion, said distal end portion being secured to said distal end of said first section, said intermediate portion being located between said distal end portion and said proximal end portion and being configured to be pulled during a deployment mode of operation to cause said third section to pivot with respect to said second section at said second pivotable joint whereupon said second section and said third section extend at an angle to each other with a distal end of said third section being immediately adjacent said distal end of said first section, whereupon a portion of said first section and a portion of at least one of a distal end of said second section and said distal end of said third section form a liver support surface configured to be disposed under a portion of the liver to lift the liver during a lifting mode of operation.

A method of lifting the liver of a patient, the patient having a liver, an abdominal cavity, an abdominal wall, and a diaphragm, said method comprising:

• providing an intra-abdominal liver retraction device comprising a first section, a second section, a third section and a flexible filament, said first and second sections being secured together at a first pivotable joint, said first section having a distal end and a proximal end, said second section having a generally linear elongated shape, said third section having a generally linear shape and being pivotably connected to said second section by a second pivotable joint, whereupon said third section extends parallel to said second section, said second pivotable joint being releasable, said second and said third sections being configured to extend parallel to each other, said flexible filament coupling said first, second and third sections together and having a distal end portion and a proximal end portion, said distal end portion being secured to said distal end of said first section;
• disposing said second and third sections so that they are substantially parallel to each other and pivoting said first member about said first pivotable joint so that said second and third sections are substantially collinear with said first section;
• introducing said first section through an instrument port extending through the abdominal wall into the abdominal cavity during an insertion mode of operation to cause said first section to readily pass through said instrument port followed by said second and third sections;
• grasping portions of said intra-abdominal liver retraction device and pulling said proximal end portion of said filament during a deployment mode of operation to cause said third section to pivot with respect to said second section at said second pivotable joint whereupon said second section and said third section extend at an angle to each other with a distal end of said third section being immediately adjacent said distal end of said first section and with a portion of said first section and a portion of at least one of a distal end of said second section and said distal end of said third section forming a liver support surface;
• and
• disposing at least a portion of said liver support surface under a portion of the liver to lift the liver during a lifting mode of operation.