Laparoscopic liver resection with the water-jet dissector

Abstract

Laparoscopic liver resection requires careful patient selection. Tumor size and location have a major influence on the feasibility of a laparoscopic operation. Isolation and ligation of blood vessels and bile ducts after selective liver dissection by suitable techniques are important for visual control of the operating field. Since the Jet-Cutter has proven to give excellent clinical results in conventional liver surgery, we carried out laparoscopic liver resections with the Jet-Cutter in six patients. Five tumors were located in the left liver lobe; the fifth was in segment 6. There were no intra- or postoperative complications. The patients were discharged from the hospital after a mean of 5.4 +/- 2.1 days.

Laparoscopic liver resection of benign liver tumors

“…Practically, when taking into account the restrictive philosophy of surgery in benign liver tumors and the need for adequate selection of patients, we believe that the performance of laparoscopic surgery in the management of benign hepatocellular tumors should be limited to less than 10% of the patients referred to expert HPB centers. On the other hand, as demonstrated in this and other series [44][45][46][47][49][50][51], only limited liver resections (namely nonanatomical resections and segmentectomies or re´gle´e left lateral segmentectomies) can be safely performed through a laparoscopic approach. Such selection of liver resections limited to one or two liver segments is encountered in most reported series.…”

“…However, the first true anatomical liver resection, namely a left lateral segmentectomy, was reported in 1996 by Azagra et al [39]. There has been an increasing number of publications concerning the laparoscopic management of benign liver tumors for surgical biopsy [40], resection [41][42][43][44][45][46][47], or local ablation [48]. Except for two recent European published series [49][50][51] most of these articles report a limited number of patients with limited follow-up.…”

New application of the bipolar vapor plasma coagulation system for laparoscopic major liver resections

“…Generally, parenchymal transection techniques using open liver resections have been implemented using the laparoscopic approach [3,4,9]. More recently, liberal use of stapling devices has been recommended as a safe method for performing the liver parenchyma [1].…”

The use of water-jetting technology in prostheses revision surgery?First results of parameter studies on bone and bone cement

“…They are called "Water-Jet Dissector, " "Water-Jet Scalpel," or simply "Jet Cutter," and are used as hand-held or even laparoscopic instruments. 28,29 The small, precise, and noncontacting cuts, the essentially cold cutting process, as well as the selective cutting of tissues with different elasticity are the main advantages of water-jet cutting. The water jet allows separation and dissection of biological structures.…”