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Liver resection using a water jet.

Y Une1, J Uchino, T Horie

  • 11st Department of Surgery, Hokkaido University School of Medicine, Sapporo, Japan.

Cancer Chemotherapy and Pharmacology
|January 1, 1989
PubMed
Summary
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The water-jet method offers a safe and effective approach for hepatic resection, preserving delicate intrahepatic vessels. This technique minimizes blood loss and shows promise for both normal and cirrhotic livers.

Area of Science:

  • Hepatobiliary Surgery
  • Surgical Technology

Background:

  • Hepatic resection is a critical surgical procedure.
  • Conventional methods for liver tissue dissection carry risks of damaging vital intrahepatic vessels and significant blood loss.
  • The water-jet method presents a novel approach to liver tissue dissection.

Purpose of the Study:

  • To evaluate the efficacy and safety of the water-jet method in hepatic resection.
  • To compare the water-jet method with conventional techniques in terms of vessel preservation and blood loss.
  • To assess the applicability of the water-jet method in both normal and cirrhotic livers.

Main Methods:

  • A comparative study involving 35 patients undergoing hepatic resection using the water-jet method.
  • Utilized a fine water-jet (0.15 mm nozzle) at pressures of 12-20 kg/cm² with saline solution.

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  • Compared outcomes with previously used conventional surgical methods.

    • Main Results:

    • The water-jet method successfully preserved intrahepatic vessels larger than 0.2 mm in normal liver parenchyma.
    • Optimal jet pressure (15-16 kg/cm²) significantly reduced blood loss during dissection.
    • While effective, dissection of cirrhotic liver parenchyma required longer operation times compared to normal liver.
    • The water-jet method produced a smoother cut surface than CUSA but caused air bubble formation.

    Conclusions:

    • Controlled water-jet application at optimal pressure ensures safe hepatic resection in both normal and cirrhotic livers.
    • The water-jet method demonstrates potential for widespread application due to its simplicity and cost-effectiveness.
    • Further investigation into managing air bubble formation may enhance its utility.