gms | German Medical Science

Introduction: Postoperative morbidity and mortality after liver resection is closely related to the degree of intraoperative blood loss, the majority of which occurs during transection of the liver parenchyma. Therefore, many approaches and devices have been developed to limit bleeding, but none of them has achieved perfect results up to now. This current chronic experimental animal study aimed to compare the safety and efficacy of the LigaSure™ Vessel Sealing System (LVSS) with the stapler technique, which is one of the modern techniques for transection of the parenchyma in liver surgery.

Material and methods: Sixteen pigs underwent a left liver resection (LLR). Eight pigs received a LLR using an Endo GIA and in the other eight the liver parenchyma was transected and simultaneously sealed by the LVSS. The operating time, transection time, blood loss during transection and time of hemostasis were measured on the day of LLR. Animals were re-explored on postoperative day 7 (POD 7) and the transection surface was ob (POD 0) served for fluid collection, necrosis and other pathologies. A biopsy was taken for histopathological examination.

Results: All animals survived until POD 7. Operating time and transection time of the liver parenchyma on POD 0 was significant shorter in the stapler group. The blood loss during transection, the time of hemostasis and the number of taken sutures for hemostasis on POD 0, the morbidity rate, as well as the histopathological examination on POD 7 were not significant different in both groups, with a trend to a reduced overall morbidity in the LVSS group. However, the material costs were significant higher in the stapler group compared to the LVSS group.

Conclusion: In our present chronic experimental animal study, LVSS seems to be safe as well as comparable with the stapler technique for transection of the parenchyma in liver surgery regarding the morbidity and mortality. Additionally, LVSS reduces significant material costs; however the transection time is significant longer compared to the stapler resection technique.