Parenchymal transection with ultrasonic scalpel in liver resection

BackgroundThere is no ideal tool for parenchymal transection in liver resection and bleeding is still a major complication. The purpose of this study was to evaluate the usefulness of an ultrasonic scalpel and to describe our clinical experience in open liver resection.MethodsAn ultrasonic scalpel was used in seven consecutive patients undergoing liver resection. During parenchymal transection coagulation shears were used with the power level set at 2 or 3, and the blunt blades were selected.ResultsIn each case, bleeding from the liver parenchyma was trivial, but haemostasis of large vessels required suture ligation. Postoperatively none of the patients experienced local technical complications such as haematoma, bile leak or infection.DiscussionAlthough complete haemostasis of large vessels cannot be achieved, the ultrasonic scalpel may be used for parenchymal transection in liver resection to reduce blood loss. Larger series of patients are needed before a definitive statement regarding the efficacy of this method can be made.