[A new fluid-jet dissector in hepatobiliary surgery]

Area of Science:

• Hepatobiliary Surgery
• Surgical Instrumentation

Background:

• Advancements in surgical techniques are crucial for improving outcomes in major hepatic resections.
• Existing tools like ultrasonic dissectors and low-pressure water jets have limitations in efficacy and ease of use.

Purpose of the Study:

• To introduce and evaluate a novel high-pressure, high-velocity water jet system for hepatic resections and biliodigestive surgery.
• To compare the performance of this new water jet technology against established surgical methods.

Main Methods:

• The study involved the application of a high-pressure (200-600 Bars) and high-velocity (>300 m/sec) water jet with low flux.
• The instrument was utilized in 22 major hepatic resections (including left, extended left, right, extended right, and segmental resections) and 6 peripheral biliodigestive bypasses.
• Performance was assessed based on blood loss, surgical field visibility, fluid usage, and dissection efficiency.

Main Results:

• The high-pressure water jet demonstrated low blood loss and excellent visibility during procedures.
• The system required minimal fluid, thereby reducing the risk of complications.
• Dissection of both fibrous and normal liver parenchyma was rapid and the instrument was easy to use.

Conclusions:

• The new high-pressure, high-velocity water jet is an effective and advantageous tool for complex hepatic resections.
• This technology enhances surgical precision and efficiency in biliodigestive surgery.
• It represents a significant improvement over previous water jet devices and ultrasonic dissectors.