Laparoscopic liver resection in domestic pigs using an ultrasonic dissector

Abstract

In an experimental study laparoscopic partial liver resection with an ultrasonic dissector was evaluated. Eight domestic pigs with a body weight of approximately 25kg were operated using an ultrasonic dissector during temporary occlusion of the hepatoduodenal ligament (Pringle manoeuvre). Peripheral parts of the liver were resected. Haemostatis was accomplished using electro-coagulation for smaller vessels and titan-clips for larger ones. The same techniques were used for bile duct ligation. One animal died during surgery from undetected bleeding within the lesser sac, which was attributed to the Pringle manoeuvre. The postoperative course of the other animals was uneventful. Three weeks after the initial operation, the animals underwent laparoscopy to evaluate the result. Laparoscopic partial liver resection can be performed using an ultrasonic dissector. The line of resection is determined by the position of the trocars. The combination of electro-coagulation of delicate and clipping of larger blood vessels and bile ducts proved to be sufficient. Three weeks postop the cut surface was covered by the major omentum or adjacent liver parts and had healed completely. Necroses, abscesses or bile fistulae were not found.

Key Words:

• laparoscopic liver resection
• liver surgery
• Pringle manoeuvre
• ultrasonic dissector