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Laparoscopic Hepatic Transection Using an Ultrasonically Activated Device

  • Luigi Cioffi
  • Andrea Belli
  • Paolo Limongelli
  • Gianluca Russo
  • Alberto D’Agostino
  • Corrado Fantini
  • Giulio BelliEmail author
Chapter

Abstract

The introduction of new technological devices for efficient and fast hemostatic control during parenchymal transection has greatly enhanced the diffusion and safety of the laparoscopic approach in the field of liver surgery. In this chapter we review the usefulness of the ultrasonically activated device (USAD) for dissection of liver parenchyma during laparoscopic liver resection. Among the wide panorama of available devices, the USAD technology in our experience of 69 laparoscopic liver resections was revealed to be a useful tool in both the dissection and parenchymal transection phases. For instance, the Pringle maneuver was rarely needed to achieve a safe coagulating effect, even when prepared in case of major bleedings. USAD was demonstrated to be extremely efficient in mobilizing the liver by rapid and blood-less dissection of all suspending ligaments. Though there is a lack of data based on well-conducted controlled studies and further studies on a greater number of patients are needed, according to our experience, utilization of USAD may help to minimize blood loss during liver resection regardless of the condition of the liver, even in case of cirrhosis.

Keywords

Liver Resection Liver Surgery Laparoscopic Liver Resection Pringle Maneuver Parenchymal Transection 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Supplementary material

ESM 1 (VIDEO 17,597 KB)

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Copyright information

© Springer-Verlag Italia 2012

Authors and Affiliations

  • Luigi Cioffi
  • Andrea Belli
  • Paolo Limongelli
  • Gianluca Russo
  • Alberto D’Agostino
  • Corrado Fantini
  • Giulio Belli
    • 1
    Email author
  1. 1.Department of General and Hepato-Pancreato-Biliary SurgeryS.M. Loreto Nuovo HospitalNaplesItaly

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