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Laparoscopic liver resection with “ultrasonic scalpel mimic CUSA" technique

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A Correction to this article was published on 09 September 2022

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Abstract

Background

Liver parenchymal transection is the most critical step for laparoscopic liver resection (LLR). Ultrasonic scalpel (Harmonic) is a common used energy instrument in LLR; however, it is only recommended for superficial layer transection and the Cavitron Ultrasonic Surgical Aspirator (CUSA) is recommended for deep layer dissection. We herein introduce the “Harmonic mimic CUSA” technique for LLR.

Methods

We retrospectively reviewed the medical records of the patients who underwent LLR using CUSA or the “Harmonic mimic CUSA” for parenchymal transection between July 2018 and October 2020 at West China Hospital of Sichuan University. Observation indicators included general demographic information, operative time, intraoperative blood loss, blood transfusion volume, complication rate, hospital stay, and the costs. Perioperative data was compared between the two groups by propensity score matching analysis (PSM).

Results

A total of 298 patients, including 192 in Harmonic group and 106 in CUSA group, were enrolled in this study. After a 1:1 PSM, 99 patients using “Harmonic mimic CUSA” were matched with 99 patients via CUSA for parenchymal transection in LLRs. The Harmonic group had significantly less intraoperative blood loss (mean, 150 ml vs. 250 ml, P < 0.001), shorter operative time (mean 170 min vs. 250 min, P < 0.001) and less costs (mean 6723$ vs. 8307$, P < 0.001). The conversion to laparotomy, length of postoperative hospital stay, complications were comparable between the two groups. There perioperative mortality was nil.

Conclusion

The “Harmonic mimic CUSA” technique is safe, simple and feasible for LLR, which may be an alternative to CUSA for LLR.

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Funding

This work was supported by grants from the National Natural Science Foundation of China (No. 81602910, No. 81302344, and No. 81802095) and the Sichuan Science and Technology Program (No. 2019YFS0370, No. 2019YFS0372, and No.2022YFS0090).

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Author notes

  1. Yubo Yang and Yufu Peng have contributed equally to this study and shared first authorship.

Authors and Affiliations

  1. Department of Liver Surgery & Liver Transplantation Center, West China Hospital, Sichuan University, 37 Guo Xue Road, Chengdu, 610041, Sichuan Province, China

    Yubo Yang, Yufu Peng, Kefei Chen, YongGang Wei, Bo Li & Fei Liu

Authors
  1. Yubo Yang
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  2. Yufu Peng
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  3. Kefei Chen
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  4. YongGang Wei
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  5. Bo Li
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  6. Fei Liu
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Contributions

YY: designed research/study, performed research/study, collected data, analyzed data, wrote the paper, edited the manuscript. YP and KC: collected data, analyzed data. BL and YGW: reviewed/edited the manuscript. FL: designed research/study, performed research/study, reviewed the manuscript, revised the manuscript.

Corresponding author

Correspondence to Fei Liu.

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Disclosures

Yubo Yang, Yufu Peng, Kefei Chen, YongGang Wei, Bo Li, Fei Liu have no conflicts of interest or financial ties to disclose.

Ethical approval

This study was approved by the clinic trial ethics committee of West China hospital (NO.20211291).

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Yang, Y., Peng, Y., Chen, K. et al. Laparoscopic liver resection with “ultrasonic scalpel mimic CUSA" technique. Surg Endosc 36, 8927–8934 (2022). https://doi.org/10.1007/s00464-022-09341-4

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  • DOI: https://doi.org/10.1007/s00464-022-09341-4

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