Efficacy and Safety of a Simple Auxiliary Liver Suspension Device in Complex Laparoscopic Hepatectomy: A Multicenter Randomized Clinical Trial

ABSTRACT Purpose To evaluate the efficacy and safety of a novel auxiliary liver suspension device in complex laparoscopic hepatectomy. Methods A total of 253 patients with hepatocellular carcinoma (HCC) undergoing complex laparoscopic hepatectomy at the Third Affiliated Hospital of Naval Medical University, Sichuan Provincial People's Hospital, and Xuzhou Municipal First People's Hospital between July 2023 and August 2024 were enrolled. Patients were randomized into two groups: the suspension group ( n = 127), utilizing a simple liver suspension device, and the control group ( n = 126), without the device. Perioperative outcomes—including hospital stay, intraoperative blood transfusion rate, blood loss, operative time, cumulative Pringle time, and complication rates—were compared between the groups. Results No significant differences were observed in conversion rate (1.6% versus 3.2%; p = 0.672), length of stay (11.0 [10.0–13.0] days versus 11.0 [9.8–13.0] days; p = 0.678), and transfusion rate (1.6% versus 3.2%; p = 0.672). Patients in the suspension group demonstrated shorter operation time (179.0[137.0–228.0] minutes versus 219.5[189.8–285.0] minutes; p < 0.001), cumulative Pringle time (37.0 [30.0–45.0] minutes versus 37.0 [30.0–60.0] minutes; p < 0.001), reduced blood loss (140.0[100.0–200.0] mL versus 200.0[150.0–262.5] mL; p < 0.001), and a lower complication rate (10.2% versus 19.0%; p = 0.047). Conclusion The use of a simple liver suspension device in complex laparoscopic hepatectomy significantly reduces operative and cumulative Pringle times, minimizes intraoperative blood loss, enhances surgical safety, and supports postoperative recovery. Trial Registration ChiCTR2300075994