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Surgical Endoscopy

Published in:

01-02-2007

Laparoscopic parenchymal division of the liver in a porcine model: comparison of the efficacy and safety of three different techniques

Authors: U. Jersenius, D. Fors, S. Rubertsson, D. Arvidsson

Published in: Surgical Endoscopy | Issue 2/2007

Abstract

Background

Bleeding is a known and CO₂ embolization a suggested risk factor for increased morbidity after laparoscopic liver resection. Devices for laparoscopic liver parenchymal transection must be evaluated for safety in this context.

Method

Twelve piglets underwent laparoscopic surgery during CO₂ pneumoperitoneum, each animal receiving three 6 cm long transections into the liver parenchyma made with ultrasonic dissector, ultrasonic shears and vessel sealing system, respectively. Endpoints were bleeding, operation time and gas embolization. The transections and embolization events, evaluated with transesophageal echocardiography, were video recorded. Bleeding and embolization were also assessed on video tapes and operating time measured. Arterial blood gases were recorded on line.

Results

The ultrasonic dissector was least advantageous in terms of bleeding and operation time. Gas embolization was more frequent with the vessel sealing system than with the ultrasonic dissector and ultrasonic shears. During two episodes of gas embolization, pCO₂ increased and pO₂ and pH decreased.

Conclusions

Use of all three devices is feasible. Bleeding and operation time are greatest with the ultrasonic dissector. Gas embolization occurs during transection, though in most instances it is completely harmless. Laparoscopic liver surgery with these techniques used may pose a risk of gas embolization with clinical implications. Monitoring for such events is probably to be recommended.

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Title: Laparoscopic parenchymal division of the liver in a porcine model: comparison of the efficacy and safety of three different techniques
Authors: U. Jersenius
D. Fors
S. Rubertsson
D. Arvidsson
Publication date: 01-02-2007
Publisher: Springer US
Published in: Surgical Endoscopy / Issue 2/2007
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-006-0758-0

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Laparoscopic parenchymal division of the liver in a porcine model: comparison of the efficacy and safety of three different techniques

Abstract

Background

Method

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Method

Results

Conclusions

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