Comparison of 5 Surgical Techniques for Partial Liver Lobectomy in the Dog for Intraoperative Blood Loss and Surgical Time

Abstract

Although skeletonization and individually clipping the vessels had the highest blood loss, it still was <7.5% of total blood volume. All 5 techniques should be safe for clinical use in small to medium sized dogs up to 26 kg.

Facilitation of Soft Tissue Surgery

“…Disadvantages include incomplete ligation of vascular tissue, decrease in lumen size, leakage of air or fluid, and technical errors ( Table 1). 5,20,22,25 …”

“…22,44,45 These devices use electrothermal bipolar electrosurgery energy and pressure to induce denaturing and fusion of collagen and elastin within the vessel wall and surrounding tissues for vascular occlusion. 46 A thrombus proximal to the sealing site also contributes to occlusion of the vasculature.…”

“…Despite the need for further ancillary occlusion methods in some cases, its use is becoming the standard of care for many procedures in dogs and cats. [20][21][22][23][24] Advantages include significant decreases in operative time, decreased hemorrhage and necrosis of tissues. Disadvantages include incomplete ligation of vascular tissue, decrease in lumen size, leakage of air or fluid, and technical errors ( Table 1).…”

Liver and biliary tract

“…More blood loss may occur using the suction and clip method compared to use of the SurgiTie, LigaSure, Ultracision Harmonic Scalpel or thoracoabdominal stapling devices. 77 Temporary inflow occlusion of the hepatic artery and portal vein with an atraumatic bulldog clamp may be used to minimize hemorrhage. 7 Vascular occluding staples (hemoclips) or suturing may be used to reinforce staple lines.…”

“…A study comparing five surgical techniques for partial liver lobectomy in the dog found no difference in surgical time between techniques, but significantly more blood loss was encountered using the suction and clip method compared to use of the SurgiTie, LigaSure, Ultracision Harmonic Scalpel, or thoracoabdominal stapling devices. 77 Temporary inflow occlusion of the hepatic artery and portal vein with an atraumatic bulldog clamp may be used to minimize hemorrhage. 7…”