Patients
This prospective randomized controlled trial was approved by the Medical Ethics Committee of Jinhua Hospital Affiliated to Zhejiang University on 15 December 2020. The trial was performed from October 2021 to November 2022. Written informed consent was obtained from all patients. The study has been registered in the Chinese Clinical Trial Registry (Eighty consecutive patients who were classified as American Society of Anesthesiologists (ASA) grade I–II, aged 18–70 years, scheduled to undergo laparoscopic hepatectomy under LCVP for at least 2 h under general anesthesia, and operated on by a single surgeon were enrolled in this study. Participants with a body mass index (BMI) of > 35 kg/mAll patients who met the inclusion criteria were documented consecutively. Randomization was performed after the patients were deemed eligible and had agreed to participate in the study. The computer-generated random numbers were sealed in opaque envelopes and kept by a nurse. The envelopes were opened after the patients had entered the operating room. The patients were randomly divided into the TMH group (