Hepatic parenchymal transection using ultrasonic coagulating shears: a preliminary report

Ultrasonically activated coagulating shears (CS) can coagulate and divide blood vessels of up to medium size by a tissue-welding technique. We present an application of CS in hepatic parenchymal transection during liver surgery. Intrahepatic vessels are uncovered by the so-called forceps fracture method, and they are coagulated and divided by CS. Larger vessels are tied only on the preserving side before the application of CS. Although further refinement of the CS tip is needed, this method has the potential to significantly simplify and improve surgical procedures for hepatic parenchymal transection.