Impact of the VIO system in hepatic resection for patients with hepatocellular carcinoma

Itoh, Shinji; Fukuzawa, Kengo; Yuki, Satoshi; Okamoto, Masahiro; Kinoshita, Tadahiko; Taketomi, Akinobu; Shirabe, Ken; Wakasugi, Kenzo; Maehara, Yoshihiko

doi:10.1007/s00595-012-0306-6

Cited by 36 publications

(30 citation statements)

References 17 publications

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“…This enables fine parenchymal dissection and careful identification and exposure of the portal pedicles. ENSEAL ® (Ethicon Endo-Surgery, Cincinnati, OH) is another modern bipolar device that can coagulate tissues by contact with only one of the jaws [23–25]. This jaw can be used to thinly scoop a portion of hepatic parenchyma before picking up the scooped parenchyma with both jaws and then coagulating and cutting it.…”

Section: Discussionmentioning

confidence: 99%

Laparoscopic liver resection in the semiprone position for tumors in the anterosuperior and posterior segments, using a novel dual-handling technique and bipolar irrigation system

et al. 2014

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BackgroundHepatic tumors in the lower edge and lateral segments are commonly treated by laparoscopic liver resection. Tumors in the anterosuperior and posterior segments are often large and locally invasive, and resection is associated with a higher risk of insufficient surgical margins, massive intraoperative bleeding, and breaching of the tumor. Laparoscopic surgery for such tumors often involves major hepatectomy, including resection of a large volume of normal liver tissue. We developed a novel method of laparoscopic resection of tumors in these segments with the patient in the semiprone position, using a dual-handling technique with an intercostal transthoracic port. The aim of this study was to evaluate the safety and usefulness of our technique.MethodsOf 160 patients who underwent laparoscopic liver resection at our center from June 2008 to May 2013, we retrospectively reviewed those with tumors in the anterosuperior and posterior segments. Patients were placed supine or semilateral during surgery until January 2010 and semiprone from February 2010.ResultsBefore the introduction of the semiprone position in February 2010, a total of 7 of 40 patients (17.5 %) with tumors in the anterosuperior and posterior segments underwent laparoscopic liver resection, and after introduction of the semiprone position, 69 of 120 patients (57.5 %) with tumors in the anterosuperior and posterior segments underwent laparoscopic liver resection (P < 0.001). There were no conversions to open surgery, reoperations, or deaths. The semiprone group had a significantly higher proportion of patients who underwent partial resection or segmentectomy of S7 or S8, lower intraoperative blood loss, and shorter hospital stay than the supine group (all P < 0.05). Postoperative complication rates were similar between groups.ConclusionsLaparoscopic liver resection in the semiprone position is safe and increases the number of patients who can be treated by laparoscopic surgery without increasing the frequency of major hepatectomy.Electronic supplementary materialThe online version of this article (doi:10.1007/s00464-014-3469-y) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Laparoscopic liver resection in the semiprone position for tumors in the anterosuperior and posterior segments, using a novel dual-handling technique and bipolar irrigation system

et al. 2014

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“…1,2 Hepatic resection has been established as a safe and effective treatment for HCC. 3,4 Although surgical techniques and postoperative management have recently improved, 5,6 postoperative morbidity in patients with HCC remains elevated. 7,8 Liver dysfunction is the major cause of postoperative morbidity and mortality after hepatic resection.…”

Section: Introductionmentioning

confidence: 99%

Functional remnant liver assessment predicts liver‐related morbidity after hepatic resection in patients with hepatocellular carcinoma

Itoh

Yoshizumi

Shirabe

et al. 2016

Hepatology Research

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“…1B). 10 In the majority of these single centres retrospective or observational studies the devices used are not specified and they are only described as "bipolar salinelinked sealer" or "bipolar-saline electric cautery". In general these studies showed that saline-coupled radiofrequency devices are effective in achieving intraoperative haemostasis and facilitate liver transection.…”

Section: Literature Reviewmentioning

confidence: 99%

Expert opinion on advanced techniques for hemostasis in liver surgery

Manas

Figueras

Azoulay³

et al. 2016

European Journal of Surgical Oncology (EJSO)

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Impact of the VIO system in hepatic resection for patients with hepatocellular carcinoma

Abstract: The VIO system was safe for hepatic resection and its use was associated with a significant decrease in intraoperative blood loss even in cirrhotic patients.

Cited by 36 publications

References 17 publications

Laparoscopic liver resection in the semiprone position for tumors in the anterosuperior and posterior segments, using a novel dual-handling technique and bipolar irrigation system

Laparoscopic liver resection in the semiprone position for tumors in the anterosuperior and posterior segments, using a novel dual-handling technique and bipolar irrigation system

Functional remnant liver assessment predicts liver‐related morbidity after hepatic resection in patients with hepatocellular carcinoma

Expert opinion on advanced techniques for hemostasis in liver surgery

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