A novel method using the VIO soft-coagulation system for liver resection

Soft coagulation, polyglycolic acid felt, and fibrin glue for prevention of pancreatic fistula after distal pancreatectomy

“…Therefore, the soft coagulation system is now only used for DP at our institute. Recently, Hirokawa et al 6 reported the effi cacy of a soft coagulation system in liver surgery, and that this approach decreased intraoperative blood loss without an increase in bile leakage.…”

“…5,6 Polyethylene glycolic acid (PGA) felt is a soft and fl exible absorbable nonwoven textile, and is widely used for tissue reinforcement. [7][8][9] Its attachment on a tissue is greatest when applied in combination with fi brin glue.…”

Expert opinion on advanced techniques for hemostasis in liver surgery

“…31 This technique is called "Two-surgeons technique" in the literature, since two different surgeons simultaneously operate on the patient from both sides, one with UD and the other one with a saline-linked cautery device. 27,28,30,31 Intraoperative blood loss varied from around 160 mL 32 e4000 mL, 33 while the percentage of patients receiving transfusions varied from 2% 5 e59%, 4 according to the type of resection performed and the technique used. The lowest values in blood loss were reported using UD in combination with Aquamantys Ò21,29,34 (Fig.…”

Donor Hepatectomy for Living Donor Liver Transplantation: Learning Steps and Surgical Outcome

“…Real-time cholangiography of the bile duct was introduced in 2002, and dye injection via the cystic duct at the end of dissection [12] commenced in 2002. Most recently, the dissection of hilar structures was minimized; limiting the dissection to the cut line around the portal vein, artery, and bile duct from 2007, and the energy device used for parenchymal hemostasis was changed from conventional monopolar electrocautery to irrigation bipolar electrocautery with VIO soft-coagulation system [13] from 2008 (Fig. 1b).…”