Harmonic Curved Shears System Prevent of Bile Leakage After Liver Resection in a Pig Model

• Published in: International surgery 2014-09, Vol.99 (5), p.632-639
• Main Authors: Shimoda, Mitsugi, Iwasaki, Yoshimi, Kubota, Keiichi
• Format: Article
• Language: English
• Subjects: Upper Gastrointestinal Surgery
• ISSN: 0020-8868; 2520-2456
• DOI: 10.9738/INTSURG-D-13-00078.1

We evaluated the efficacy of TachoComb (TC) collagen fleece and Harmonic Focus (HF) shears in a pig liver resection model. Pigs were divided into 3 groups of 7, in which vessels were tied with silk and TC was applied to the cut surfaces (Silk+TC group), sealed and sheared with HF and TC (HF+TC group), or sealed using HF alone (HF–TC group). After 1 month, we conducted a histologic evaluation and recorded the incidence of bile leakage with infected collections at the liver cut surface. Six pigs were evaluated in each group. In the Silk+TC group, 4 of the 6 pigs had infected collections at the cut surface. Histologically, the silk had remained under the fibrotic tissue, which contained remnants of TC fragments. In the HF+TC group, 5 of the 6 pigs also had infected collections, and histologically, TC had remained in the hard fibrotic tissues. In the HF–TC group, none of the 6 pigs had infected collections, and the histologic findings were normal. Use of the HF alone may be an effective method for preventing bile leakage in infected collections after liver resection.