Abstract
Background: Many kinds of energy device (ED) recently are developed. Not much, however, has been done to clarify how the laparoscopic liver resection would be perfomed using with ED frugally, and safely.
Method: We performed 22 laparoscopic minor hepatectomies using with a radiofrequency bipolar coagulation (RFBC) and an ultrasonic dissection (US). Under 10mmH2O intraabdominal pressure, hepatic parenchyma was coagulated and Glissonʼs sheath was sealed using RFBC via thre/four trocars stabbed. After the coagulation/seal, hepatic parenchyma was cut using US. The coagulation/seal and dissection were operated alternately, and the liver resection was performed. On the viewpoint of the ED used, we analyzed number of ED used, operation time, blood loss, postoperative complication, and days in hospital.
Results: The mean operative time of the present method with RFBC/US was 172 minutes, the mean blood loss was 95cc, and the mean days in hospital were 8.7 days. No patient had postoperative complication. There was no significant difference between the other kinds of combination such as a microwave coagulation (MW)/RFBC, and MW/an ultrasonic surgical aspirator (CUSA).
Conclusion: Apply of two EDs, which is the combination of coagulative sealer and coagulative dissector (e.g., RFBC/US), would contribute to skillful and safe laparoscopic hepatectomy.
