Preliminary experience in liver surgery using the ultrasonic scalpel

Area of Science:

• Hepatobiliary Surgery
• Surgical Technology

Background:

• Liver resections are complex procedures requiring precise tissue dissection.
• Achieving adequate hemostasis and minimizing blood loss are critical challenges in hepatic surgery.

Purpose of the Study:

• To describe the development and application of novel ultrasonic scalpel techniques for liver resections.
• To evaluate the efficacy and safety of the ultrasonic scalpel in anatomic and nonanatomic liver resections.

Main Methods:

• Utilized an ultrasonic scalpel with a saline-cooled tip vibrating at ultrasonic frequencies.
• The device selectively fragmented tissue, suspending and aspirating fragments, aiding in mesenchymal separation from blood vessels.
• Tactile feedback facilitated precise dissection, allowing division of most blood vessels between clamps or clips.

Main Results:

• The ultrasonic scalpel demonstrated improved control and hemostasis during hepatic resections in 33 patients.
• Only six patients experienced complications, with one operative death.
• The technique proved effective for both anatomic and nonanatomic liver resections.

Conclusions:

• The ultrasonic scalpel represents a significant advancement in liver resection techniques.
• Routine adoption of this method is recommended due to its enhanced safety and efficacy profile.