This paper introduces the “pulley maneuver” using the Stratafix suture to improve traction and exposure in minimally invasive hepatobiliary and pancreatic surgeries.

• Key techniques include a sling pulley for pancreatic elevation during distal pancreatectomy and a vessel loop for precise hilar lymph node dissection.
• The symmetrical anchors of Stratafix provide strong tissue-holding and adjustable multi-directional tension, potentially reducing the need for extra ports or assistants.

These innovations can streamline complex procedures, enhance visualization, and improve ergonomic handling, ultimately supporting better surgical outcomes and patient safety.