Outcomes of abdominal surgery in patients with liver cirrhosis

Table 2 Modifications in operative laparoscopic techniques in non-hepatic abdominal surgery in liver cirrhosis who underwent cholecystectomy and hernia repair

Ref.	Modified technique	Objective and advantage
Laparoscopic cholecystectomy
Friel et al[77], 1999	Use of open technique using Hassan’s trocar	Prevent inadvertent puncture of umbilical varix
Shiff et al[78], 2005	Placement of the trocar in the right paramedian position
Clark et al[79], 2001	Use of additional ports	Facilitate laparoscopic technique and prevent complications in cases of severe gallbladder inflammation
	Performance of retrograde cholecystectomy
Clark et al[79], 2001	Modified subtotal cholecystectomy
Palanivelu et al[80], 2006
Friel et al[77], 1999	Mechanical compression from introduced surgical sponges (i.e., oxidized cellulose)	Facilitate haemostasis
	Application of ultrasonic energy via harmonic scalpel
	Use of argon beam coagulator through an operative port
Laparoscopic hernia repair
Belli et al[81], 2006	Minimally invasive and tension-free laparoscopic technique	Prevent inadvertent puncture of collateral veins
		Prevent recurrence rates and wound infections
McAlister et al[82], 2003	Dual mesh prosthesis: fixation of mesh in a preperitoneal space	Prevent recurrence rates and mesh migration
	Sterile fashion of mesh insertion	Prevent wound infections