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Objectives The amount of tissue that is ablated or necrosed at the line of parenchymal transection is of clinical significance in the interpretation of resection margin status following hepatic resection. The aim of this study was to define the extent of parenchymal ablation and necrosis in liver tissue using the Harmonic Scalpel™, the LigaSure™, the Cavitron Ultrasonic Surgical Aspirator® (CUSA ®) and the Aquamantys® dissector ex vivo. Methods Mounted blocks of non-perfused bovine liver were transected using the Harmonic Scalpel™, LigaSure™, CUSA ® and Aquamantys® devices. Outcome measures included parenchymal ablation (ablation band widths and weights) and tissue necrosis band widths along the line of transection. Each experiment was replicated five times. Results All devices were associated with parenchymal ablation (Harmonic Scalpel™, 4.73 ± 1.62 mm; LigaSure™, 4.55 ± 2.02 mm; CUSA ®, 7.16 ± 2.87 mm; Aquamantys®, 4.75 ± 1.43 mm) and tissue necrosis (Harmonic Scalpel™, 1.07 ± 0.46 mm; LigaSure™, 1.36 ± 0.36 mm; CUSA ®, 0.81 ± 0.21 mm; Aquamantys ®, 0.81 ± 0.36 mm). Conclusions The Harmonic Scalpel™, LigaSure™, CUSA ® and Aquamantys ® devices were associated with bands of tissue loss along the hepatic parenchymal transection line in this benchtop cadaveric model. This should be taken into account in the interpretation of resection margin status following liver resection. © 2012 International Hepato-Pancreato-Biliary Association.
Author(s): Hammond JS, Muirhead W, Zaitoun AM, Cameron IC, Lobo DN
Publication type: Article
Publication status: Published
Journal: HPB
Year: 2012
Volume: 14
Issue: 12
Pages: 828-832
Print publication date: 01/11/2012
Online publication date: 01/11/2012
ISSN (print): 1365-182X
ISSN (electronic): 1477-2574
Publisher: Blackwell Publishing Ltd
URL: http://doi.org/10.1111/j.1477-2574.2012.00547.x
DOI: 10.1111/j.1477-2574.2012.00547.x
PubMed id: 23134184
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