The patient was preoxygenated with 100% oxygen for 15 mins on the operating table, in 20-degree reverse Trendelenburg position
with Optiflow[TM], a commercial transnasal humidified oxygen delivery system (Fisher and Paykel Healthcare Limited, Panmure, Auckland, New Zealand).
At times, it is helpful to cut the falciform ligament near the liver to expose the right side of the diaphragm completely while the patient is in steep reverse Trendelenburg position
During the operation, placing the patient in the reverse Trendelenburg position
with a tilt to the left side and continuous monitoring of blood gases may avert the supine hypotensive syndrome and prevent further respiratory difficulties.