Randomized Comparative Study between Using Harmonic Scalpel versus Cavitron Ultrasonic Surgical Aspirator with Bipolar Cautery in Living Donor Hepatectomy for Living Donor Liver Transplantation
M. A. Semary,H. Saber,Mostafa S Mohamed,Amr Abdelaal,Khaled Mansour +4 more
TL;DR: Although harmonic scalpel is a faster method, CUSA is more effective and safer with a lower complication rate despite being cumbersome and need a longer learning curve.
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Abstract: Background: Liver donation is a respectable human gift. It is essential that complications should be minimized as much as possible and must be safely performed. Aim of the work: To evaluate feasibility and safety of using CUSA for liver resection in living donor liver transplantation (LDLT) in comparison with harmonic scalpel. Patients and methods: This prospective study included 40 consecutive donors for LDLT held at Nasser Institute and Air Force Specialized Hospital during the period from September 2017 to September 2018. Results: Harmonic scalpel significantly reduced operative time (p=0.000) with a reduced blood loss (p=0.016), however it caused higher rate of biliary leakage (40% vs 15% respectively). On the other hand, CUSA showed lower bile leak leading to shorter hospital stay (p=0.000). Conclusion: Although harmonic scalpel is a faster method, CUSA is more effective and safer with a lower complication rate despite being cumbersome and need a longer learning curve.
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References
Robotic Versus Open Right Lobe Donor Hepatectomy for Adult Living Donor Liver Transplantation: A Propensity Score-Matched Analysis.
Dieter C. Broering,Yasser Elsheikh,Yasir Alnemary,Ahmed S. Zidan,Ahmed M Elsarawy,Yahia Saleh,Saleh Alabbad,Mark Sturdevant,Yao-Ming Wu,Roberto Ivan Troisi +9 more
TL;DR: RRLDH is feasible, safe, and reproducible, with significantly decreased blood loss and a shorter hospital stay compared with the open procedure, and the first 35 patients receiving the robotic procedure showed a substantial reduction in operative time, reflecting a rapid shortening of the learning curve.
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Donor safety in living donor liver transplantation: a single-center analysis of 300 cases.
TL;DR: With careful donor selection and specialized patient care, low morbidity rates and satisfactory long-term recovery can be achieved after hepatectomy for living-donor liver transplantation.
Impact of Energy Devices During Liver Parenchymal Transection: A Multicenter Randomized Controlled Trial
Naoto Gotohda,Takeharu Yamanaka,Akio Saiura,Katsuhiko Uesaka,Masaji Hashimoto,Masaru Konishi,Kazuaki Shimada +6 more
TL;DR: The hypothesis that hepatectomy with energy device is not inferior to that without energy device in terms of blood loss has been demonstrated and the use of energy devices during liver surgery is clinically meaningful as it shortens the liver transection time and reduces the incidence of postoperative bile leakage.
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Liver resection using cavitron ultrasonic surgical aspirator (CUSA) versus harmonic scalpel: a retrospective cohort study.
TL;DR: The results show the Harmonic Scalpel with TissueLink to be a safe, effective method of parenchymal division with significantly less EBL and LOS when compared to CUSA with T tissueLink.
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A prospective randomized controlled trial of hemostasis with a bipolar sealer during hepatic transection for liver resection.
Masaki Kaibori,Kosuke Matsui,Morihiko Ishizaki,Tatsuma Sakaguchi,Hideyuki Matsushima,Yoichi Matsui,A-Hon Kwon +6 more
TL;DR: CUSA with a bipolar sealer is superior to CUSA with standard BC for various hepatectomy in terms of less blood loss and faster speed of transection, with no increase in morbidity.
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