Postmortem evaluation of surgery site leakage by use of in situ isolated pulsatile perfusion after partial liver lobectomy in dogs

Abstract

Time until leakage of perfusate was greater for the pretied suture loop technique than for the other techniques, and that technique did not fail in 5 of 10 lobes. However, all techniques appeared to be safe for clinical use.

Clinical evaluation of a pre‐tied ligating loop for liver biopsy and liver lobectomy

“…The ligating loop theoretically has several advantages over other methods of liver lobectomy, and compared favourably with four other methods of liver lobectomy (energy‐based sealer‐divider, harmonic scalpel, suction with clip application and suction with thoracoabdominal stapler) in both experimental cadaveric and in vivo dog studies (Risselada and others ,). Mean procedure time for liver lobectomy had been an initial objective outcome measure; however, it was elected not to evaluate this parameter due to inconsistent recording of the time for the actual liver lobectomy itself.…”

“…Traditional methods of partial liver lobectomy via coeliotomy include the suture fracture or guillotine technique, the “finger fracture” technique, or use of thoracoabdominal or endolinear staplers across the lobe with or without prior parenchymal dissection (Lewis and others , Bellah , Mayhew and Weisse ). More recently, vessel‐sealing and cutting devices employing high current, low‐frequency radiofrequency energy (LigaSure; Valley Lab‐Tyco Healthcare) and an ultrasonically activated scalpel (Harmonic Scalpel; Ethicon Endosurgery) have been employed (Vasanjee and others , Risselada and others ,). Regardless of the technique employed, haemostasis is paramount because of the vascular nature of the liver and potential coagulation abnormalities associated with liver pathology (Mayhew and Weisse ).…”

“…However, the ligating loop has a theoretical increased ease of application and safety due to the self‐locking knot. An experimental evaluation of postmortem surgical site leakage following partial liver lobectomy in healthy dogs via midline coeliotomy revealed the ligating loop to be superior to other techniques of liver lobectomy, with a lower rate of leakage and a greater time to leakage of perfusate following perfusion at supra‐physiologic pressures (Risselada and others ,). The pre‐tied ligating loop has not yet been evaluated in a clinical setting in dogs with naturally occurring liver disease.…”

Short-term outcome following partial or complete liver lobectomy with a commercially prepared self-ligating loop in companion animals: 29 cases (2009–2012)

“…11,12 Lobectomies performed with an SLL were the most resistant to leakage, indicating it may be an acceptable technique for clinical use. 11,12 Lobectomies performed with an SLL were the most resistant to leakage, indicating it may be an acceptable technique for clinical use.…”

“…11,12 Lobectomies performed with an SLL were the most resistant to leakage, indicating it may be an acceptable technique for clinical use. 11,12 Use of SLLs for large liver lobectomies in clinically affected animals, their ability to excise masses that exceed the 8-cm diameter of the preformed loop, and their effectiveness for this indication in companion animal species other than dogs and cats have not been previously reported. 11,12 Use of SLLs for large liver lobectomies in clinically affected animals, their ability to excise masses that exceed the 8-cm diameter of the preformed loop, and their effectiveness for this indication in companion animal species other than dogs and cats have not been previously reported.…”