Skip to main content

Advertisement

Log in

Practical Usefulness of Ultrasonic Surgical Aspirator with Argon Beam Coagulation for Hepatic Parenchymal Transection

  • Published:
World Journal of Surgery Aims and scope Submit manuscript

Abstract

The objective of this study was to evaluate the effectiveness and feasibility of using the Cavitron ultrasonic surgical aspirator (CUSA) with argon beam coagulation (ABC) during hepatic resection, in comparison with a conventional method using CUSA with bipolar cautery. Between April 2003 and March 2004, a series of 14 consecutive patients underwent hepatic resection of normal liver. Hepatectomies were performed using CUSA and bipolar irrigation electrocautery (BP) in eight patients between April 2003 and December 2003. CUSA and an ABC were used in six patients between January 2004 and March 2004. There were no differences in patient characteristics between the two groups. Blood loss per area of transected liver surface was significantly lower for CUSA with ABC than for CUSA with BP (2.9 ± l.44 vs. 6.33 ± 3.14 ml/cm2). Furthermore, the speed of resection, defined as resection time per area of transected liver surface, was significantly greater for CUSA with ABC than for CUSA with BP (0.53 ± 0.14 vs.2.18 ± 1.73 min/cm2). This new technique of combining CUSA with ABC can decrease blood loss during hepatic parenchymal transection and shorten the resection time.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Hodgson WJ, Poddar PK, Mencer EJ, et al. Evaluation of ultrasonically powered instruments in the laboratory and in the clinical setting. Am. J. Gastroenterol. 1979;72:133–140

    CAS  PubMed  Google Scholar 

  2. Rees M, Plant G, Wells J, et al. One hundred and fifty hepatic resections: evolution of technique towards bloodless surgery. Br. J. Surg. 1996;83:1526–1529

    CAS  PubMed  Google Scholar 

  3. Putnam CW. Techniques of ultrasonic dissection in resection of the liver. Surg. Gynecol. Obstet. 1983;515:474–478

    Google Scholar 

  4. Fasulp F, Giori A, Fissi S, et al. Cavitron ultrasonic surgical aspirator (CUSA) in liver resection. Int. Surg. 1992;77:64–66

    Google Scholar 

  5. Tabuse K, Katsumi M, Kobayashi M, et al. Microwave surgery: hepatectomy using a microwave tissue coagulator. World J. Surg. 1982;9:136–143

    Article  Google Scholar 

  6. Berghiti J, Farges O. Liver surgery in the cirrhotic patient. In Mazziotti A, Cavallari A, (eds), Techniques in Liver Surgery, London, Greenwich Medical Media, 1997;69–77

    Google Scholar 

  7. Makuuchi M, Hasegawa H, Yamazaki S. Ultrasonically guided subsegmentectomy. Surg. Gynecol. Obstet. 1985;161:346–350

    CAS  PubMed  Google Scholar 

  8. Okamoto T, Nakasato Y, Yanagisawa S, et al. Hepatectomy using the coagulating shears type of ultrasonically activated scalpel. Dig. Surg. 2001;18:427–430

    Article  CAS  PubMed  Google Scholar 

  9. Yamada T, Sasaki Y, Yokoyama Y, et al. Practical usefulness of bipolar scissors in hepatectomy. Hepatotgastroenterology 2002;49:596–600

    Google Scholar 

  10. Horgan PG. A novel technique for parenchymal division during hepatectomv. Am. J. Surg. 2001;181:236–237

    Article  CAS  PubMed  Google Scholar 

  11. Belghiti J, Noun R, Malafosse R, et al. Continuous versus intermittent portal triad clamping for liver resection: a controlled study. Ann. Surg. 1999;229:369–375

    Article  CAS  PubMed  Google Scholar 

  12. Hodgson WJ, Morgan J, Byrne D, et al. Hepatic resections for primary and metastatic tumors using the ultrasonic surgical dissector. Am. J. Surg. 1992;163:246–250

    Article  CAS  PubMed  Google Scholar 

  13. Fan ST, Lai EC, Lo CM, et al. Hepatectomy with an ultrasonic dissector for hepatocellular carcinoma. Br. J. Surg. 1996;83:117–120

    CAS  PubMed  Google Scholar 

  14. Takayama T. Makuuchi M, Kubota K, et al. Randomized comparison of ultrasonic vs clamp transection of the liver. Arch. Surg. 2001;136:922–928

    Article  Google Scholar 

  15. Kwon AH, Inui H, Kamiyama Y. Successful laparoscopic haemostasis using argon beam coagulator for blunt traumatic splenic injury. Eur, J. Surg. 2001;167:316–318

    Article  CAS  Google Scholar 

  16. Postema RR, Plaisier PW, ten Kate FJ, et al. Haemostasis after partial hepatectomy using argon beam coagulation. Br. J. Surg. 1993;80:1563–1565

    CAS  PubMed  Google Scholar 

  17. Stifelman MD, Sosa RE, Nakada SY, et al. Hand-assisted laparoscopic partial nephrectomy. J. Endourol 2001;15:161–164

    Article  CAS  PubMed  Google Scholar 

  18. The Brisbane 2000 terminology of liver anatomy and resections. HPB 2000;2:333–339

    Google Scholar 

  19. Yamanaka N, Okamoto E, Kuwata K, et al. A multiple regression equation for prediction of posthepatectomy liver failure. Ann. Surg 1984;200:658–663

    CAS  PubMed  Google Scholar 

  20. Nagano Y, Togo S, Tanaka K, et al. Risk factors and management of bile leakage after hepatic resection. World J. Surg. 2003;7:695–698

    Article  Google Scholar 

  21. Yamamoto Y, Ikai I, Kume M, et al. New simple technique for hepatic parenchymal resection using Cavitron ultrasonic surgical aspirator and bipolar cautery equipped with a channel for water dripping. World J. Surg. 1999;23:1032–1037

    Article  CAS  PubMed  Google Scholar 

  22. Dunham CM, Cornwell EE III, Militello P. The role of the argon beam coagulator in splenic salvage. Surg. GynecoL Obstet, 1991;173:179–182

    CAS  Google Scholar 

  23. Go PM, Goodman GR, Bruhn EW, et al. The argon beam coagulator provides rapid hemostasis of experimental hepatic and splenic hemorrhage in anticoagulated dogs. J, Trauma 1991;31:1294–1300

    Article  CAS  Google Scholar 

  24. Sitzmann JV, Greene PS. Perioperative predictors of morbidity following hepatic resection for neoplasm: a multivariate analysis of a single surgeon’s experience with 105 patients. Ann. Surg. 1994;219:13–17

    CAS  PubMed  Google Scholar 

  25. Nakajima Y, Shimamura T, Kamiyama T, et al. Control of intraoperative bleeding during liver resection: analysis of a questionnaire sent to 231 Japanese hospitals. Surg. Today 2002;32:48–52

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Yasuhiko Nagano M.D., Ph.D..

Rights and permissions

Reprints and permissions

About this article

Cite this article

Nagano, Y., Matsuo, K., Kunisaki, C. et al. Practical Usefulness of Ultrasonic Surgical Aspirator with Argon Beam Coagulation for Hepatic Parenchymal Transection. World J. Surg. 29, 899–902 (2005). https://doi.org/10.1007/s00268-005-7784-2

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00268-005-7784-2

Keywords

Navigation