Hepatic resection using the harmonic scalpel

We describe herein our technique of performing extensive resection of the liver by blunt dissection in combination with excision using a harmonic scalpel. A ball coagulator was inserted at 3-cm intervals along the proposed cutting line in the liver, and the liver parenchyma between these holes was t...

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Bibliographic Details
Published in:Surgery today (Tokyo, Japan) Japan), 2000-01, Vol.30 (10), p.959-962
Main Authors: Sugo, H, Mikami, Y, Matsumoto, F, Tsumura, H, Watanabe, Y, Kojima, K, Futagawa, S
Format: Article
Language:English
Subjects:
Adult
Aged
Equipment Design
Female
Hepatectomy - adverse effects
Hepatectomy - instrumentation
Hepatectomy - methods
Humans
Liver Neoplasms - surgery
Male
Middle Aged
Postoperative Hemorrhage
Treatment Outcome
Ultrasonics
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Summary:We describe herein our technique of performing extensive resection of the liver by blunt dissection in combination with excision using a harmonic scalpel. A ball coagulator was inserted at 3-cm intervals along the proposed cutting line in the liver, and the liver parenchyma between these holes was then cut using coagulation shears. Regardless of the condition of the liver, good coagulation and cutting were achieved using the harmonic scalpel without vascular occlusion when dividing the shallow layer of the liver, and no complications in association with the harmonic scalpel, such as postoperative bleeding, bile leakage, or abscess formation at the cut margins, occurred. In the deep layer below the main trunk of the hepatic vein, blunt dissection was used, since it was difficult to achieve sufficient control of bleeding from large vessels using the harmonic scalpel alone. Therefore, when used in combination with other techniques, the harmonic scalpel appears to be an effective device for liver surgery that minimizes bleeding and decreases the vascular clamping time.
ISSN:0941-1291
1436-2813
DOI:10.1007/s005950070055