Faster and safer resection with a stapler device: randomised, controlled trial of laparoscopic liver resection in a porcine model

• Introduction. Many surgeons use stapling during liver resection. The stapler has the potential to close all luminal structures in the liver tissue and thus result in minimal bleeding, reduced danger of gas embolism, and a faster surgery. Material. Sixteen piglets where randomised into two groups receiving either laparoscopic liver resection with a vessel sealing system and an ultrasonic dissector (group-L) or with stapling (group-S). Pneumoperitoneum at 16 mmHg pressure was used. Gas embolism was detected with transesophageal ultrasound and intra-operative bleeding estimated. Monitoring of gas exchange with continuous recording of PaCO2, PaO2, end-tidal CO2, and pH was used. Invasive monitoring of systemic and pulmonary circulation was performed. Results. Stapling resulted in less bleeding (P = 0.026), less gas embolism (P = 0.001), and a shorter operating time (P = 0.004). Conclusion. In this animal model, stapling of the liver parenchyma led to a faster and safer resection compared to the use of a vessel sealing system and an ultrasonic dissector.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Kirurgi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Surgery (hsv//eng)

Nyckelord

Pneumoperitoneum

laparoscopy

liver surgery

stapling device

gas embolism

bleeding

Publikations- och innehållstyp

vet (ämneskategori)

art (ämneskategori)