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Updated: Jul 2, 2026
Modified Laparoscopic Anatomic Hepatectomy: Two-Surgeon Technique Combined with the Simple Extracorporeal Pringle Maneuver
Published on: June 16, 2023
The use of water-jet dissection in open and laparoscopic liver resection
H G Rau1, A P Duessel, S Wurzbacher
1Surgical Department of Visceral, Thoracic and Vascular Surgery, Amper-Klinikum Dachau, Dachau, Germany. gabriele.stichlmayr@amperkliniken.de
Background:
We intend to give an overview of our experiences with the implementation of a new dissection technique in open and laparoscopic surgery.
Methods:
Our database comprises a total of 950 patients who underwent liver resection. Three hundred and fifty of them were performed exceptionally with the water-jet dissector. Forty-one laparoscopic partial liver resections were accomplished.
Results:
Using the water-jet dissection technique it was possible to reduce the blood loss, the Pringle- and resection time in comparison to CUSA and blunt dissection. In the last five years we could reduce the Pringle-rate from 48 to 6% and the last 110 liver resections were performed without any Pringle's manoeuvre. At the same time, the transfusion-rate decreased from 1.86 to 0.46 EC/patient. In oncological resections, the used dissection technique had no influence on long-time survival.
Conclusions:
The water-jet dissection technique is fast, feasible, oncologically safe and can be used in open and in laparoscopic liver surgery.
