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NATHANSON LIVER RETRACTION SYSTEM
INTENDED USE
The Nathanson Liver Retraction System is intended to be
used to retract the left lobe of the liver during surgery in
the upper gastro-intestinal region.
DESCRIPTION
• Available in four sizes.
• Can be used with the Murdoch Mechanical Arm.
• Stainless steel construction with matte metal finish to
reduce light reflection.
• Small NLR has a 45 mm distal tip distance.
• Medium NLR has a 55 mm distal tip distance.
• Large NLR has a 75 mm distal tip distance.
• Extra large NLR has a 95 mm distal tip distance.
• Supplied non-sterile.
Reference: Dr. Les Nathanson, Department of Surgery,
Royal Brisbane Hospital, Brisbane, Australia.
Reorder codes
NLRS-1100 Small retractor only.
NLRS-1010 Medium retractor only.
NLRS-1001 Large retractor only.
NLRS-1002 Extra Large retractor only.
PRECAUTIONS
• Ensure that NLR is operated and used only by the
persons trained in the procedure.
• Read, follow, and keep the instructions for use.
• Use the device only in accordance with its intended use.
• Remove the packaging and clean the NLR with the
reprocessing instructions prior to its initial sterilization.
• Do not use if NLR is damaged or defective.
INSTRUCTIONS FOR USE
The Nathanson Liver Retractor is held in place by the
Murdoch Mechanical Retraction Arm.
Reorder codes: MMA-1000
The Nathanson Liver Retractor can be held in place by
any of the following commercially available mechanical
arms:
• The Murdoch Arm. Dedicated Locking Handle.
• The BOOKWALTER® Retractor which attaches to the
horizontal flex bar.
• The Iron Intern® plus the Universal Gemma Connection
Clamp.
55mm
75mm
95mm
Setting up
Place the retractor holder on the opposite side of the
table from the surgeon's working side.
Steps for insertion
NOTE: The insertion point for the Nathanson Liver
Retractor depends upon the procedure being
performed, size of the patient and personal preference
of the surgeon. For example, when performing a Nissen
Fundoplication, an optimal site may be the point inferior
to the Xiphoid Process.
Step 1 Commence insufflation of the peritoneal cavity in
the normal manner.
Step 2 Upon obtaining set maximum pressure insert a
5 mm trocar. Remove the trocar and enlarge the tract, if
necessary with a pair of artery forceps.
Step 3 Holding the Nathanson Liver Retractor by the
handle and maintaining the curved radius in a vertical
position, insert the retractor with a twisting motion.
Do not connect the Nathanson Liver Retractor to the
retractor arm.
Step 4 Under direct vision, maneuver the curved edge
of the Nathanson Liver Retractor in a superior direction
under the left lobe of the liver.
Step 5 Continue placement of the ports. When this is
complete, attach the Nathanson Liver Retractor to the
retractor arm and elevate the liver to the desired position.
3
45mm
Front view
End view
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