Use of a bipolar vessel-sealing device for parenchymal transection during liver surgery

Most blood loss during liver resection occurs during parenchymal transection, and multiple approaches have been developed to limit blood loss. The purpose of this study was to evaluate a new bipolar vessel-sealing device in hepatic surgery, particularly whether the device would permit safe transection without routine inflow occlusion. Twenty-seven hepatic procedures were performed using the device after preliminary studies to adapt its use to the liver. Inflow occlusion was used when necessary to control blood loss but not as a routine. The device worked well for transection through normal liver during common liver operations such as right hepatectomy. It worked less well for enucleations. Inflow occlusion was used in approximately 10% of resections, exclusive of enucleations, and about 25% of these patients were transfused during surgery or in the postoperative period. We conclude that the device is a useful tool in standard liver resections.