Rubber tourniquet technique: A simple, safe, and cost-effective method of hepatic resection in neonates and infants.


Section of Pediatric Surgery, Department of Surgery, The Aga Khan University, Stadium Road, Karachi 74800, Pakistan. Electronic address: [Email]


BACKGROUND : Despite the improvements in patient care, understanding of surgical anatomy of liver and surgical techniques, liver resection is a high-risk procedure specifically in infants and neonates; whose blood volume is limited (80 ml/kg). This report shares the experience of hepatic resection with "Rubber tourniquet technique" in patients less than 6-months of age.
METHODS : Hepatic resection in a 4-month-old pair of Conjoined twins with shared liver and a 3-day old baby with large Congenital Hepatoblastoma was performed using Penrose rubber drain as a tourniquet around the liver parenchyma to reduce blood loss.
RESULTS : Blood loss was minimal (<20CC) and all the three babies survived the procedure without complications.
CONCLUSIONS : Rubber tourniquet technique is simple, safe and cost-effective for liver resections in neonates and infants with hepatic lesions and separation of conjoined twins with shared liver and it can easily be employed in resource constraint settings.


Conjoined twins,Global surgery,Hepatic resection,Hepatoblastoma,Infant,Neonates,