H G Rau1, A P Duessel, S Wurzbacher. 1. Surgical Department of Visceral, Thoracic and Vascular Surgery, Amper-Klinikum Dachau, Dachau, Germany. gabriele.stichlmayr@amperkliniken.de
Abstract
BACKGROUND: We intend to give an overview of our experiences with the implementation of a new dissection technique in open and laparoscopic surgery. METHODS: Our database comprises a total of 950 patients who underwent liver resection. Three hundred and fifty of them were performed exceptionally with the water-jet dissector. Forty-one laparoscopic partial liver resections were accomplished. RESULTS: Using the water-jet dissection technique it was possible to reduce the blood loss, the Pringle- and resection time in comparison to CUSA and blunt dissection. In the last five years we could reduce the Pringle-rate from 48 to 6% and the last 110 liver resections were performed without any Pringle's manoeuvre. At the same time, the transfusion-rate decreased from 1.86 to 0.46 EC/patient. In oncological resections, the used dissection technique had no influence on long-time survival. CONCLUSIONS: The water-jet dissection technique is fast, feasible, oncologically safe and can be used in open and in laparoscopic liver surgery.
BACKGROUND: We intend to give an overview of our experiences with the implementation of a new dissection technique in open and laparoscopic surgery. METHODS: Our database comprises a total of 950 patients who underwent liver resection. Three hundred and fifty of them were performed exceptionally with the water-jet dissector. Forty-one laparoscopic partial liver resections were accomplished. RESULTS: Using the water-jet dissection technique it was possible to reduce the blood loss, the Pringle- and resection time in comparison to CUSA and blunt dissection. In the last five years we could reduce the Pringle-rate from 48 to 6% and the last 110 liver resections were performed without any Pringle's manoeuvre. At the same time, the transfusion-rate decreased from 1.86 to 0.46 EC/patient. In oncological resections, the used dissection technique had no influence on long-time survival. CONCLUSIONS: The water-jet dissection technique is fast, feasible, oncologically safe and can be used in open and in laparoscopic liver surgery.
Entities:
Keywords:
dissection technique; hemihepatectomy; hydro-jet; liver resection; open and laparoscopic surgery; water-jet
Authors: Marcello Giuseppe Spampinato; Andrea Coratti; Luigi Bianco; Fabio Caniglia; Andrea Laurenzi; Francesco Puleo; Giuseppe Maria Ettorre; Ugo Boggi Journal: Surg Endosc Date: 2014-05-23 Impact factor: 4.584