Two-surgeon technique for liver transection using precoagulation by a soft-coagulation system and ultrasonic...

Area of Science:

• Hepatobiliary surgery
• Surgical oncology
• Minimally invasive techniques

Background:

• Hepatectomy often involves significant blood loss, impacting patient outcomes.
• The soft-coagulation system (SCS) has shown promise in reducing intraoperative bleeding.
• Evaluating novel techniques is crucial for improving hepatectomy safety and efficiency.

Purpose of the Study:

• To assess the efficacy of a two-surgeon technique employing precoagulation with SCS and Cavitron Ultrasonic Surgical Aspirator (CUSA) for liver transection.
• To compare blood loss and postoperative outcomes between the novel technique and conventional methods.

Main Methods:

• A comparative study involving 163 patients with liver tumors undergoing hepatectomy.
• Patients were divided into a conventional group (n=102) using bipolar electrocautery and CUSA, and a two-surgeon group (n=61) using SCS precoagulation and CUSA.
• Standardized surgical protocols were followed for both groups.

Main Results:

• The two-surgeon group exhibited significantly lower median blood loss (354.8 mL) compared to the conventional group (557.8 mL; p=0.0011).
• Postoperative hospital stay was significantly shorter in the two-surgeon group (12.7 days) versus the conventional group (15.5 days; p=0.0035).

Conclusions:

• The two-surgeon technique with SCS precoagulation and CUSA effectively reduces blood loss during liver transection.
• This approach is associated with reduced postoperative hospital stay, low morbidity, and mortality.
• This technique offers a valuable option for hepatobiliary surgeons seeking to optimize hepatectomy procedures.