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

Transection methods and hemostasis achievement have an impact on blood loss, and consequently on outcome and survival. However, no consensus exists on parenchymal transection or hemostasis techniques in laparoscopic liver resection (LLR). The aim of this review is to clarify the role of energy devices (ED) in LLR. ED is a generator of mechanic or electric energy transfer to an operating tool, used for transection, sealing or both. Searches were performed in PubMed, PubMed Central, Cochrane, Embase, Google Scholar in human or animal experimental models. Each study quality was graded following the GRADE system. From 1996 to 2014, 30 studies were found: five comparative, one prospective, two case-control, and 16 case series and some case reports, with level of evidence ranging from Moderate to Very Low. Since 2012, the Research and Development of new tools raised quicker than clinical studies could follow. The two main techniques emerged are blind transection versus sharp dissection: due to the low quality and heterogeneity of the studies, no firm conclusion can be drawn, but meticulous dissection of vessels usually never leads to vascular damage. As a matter of fact, ED, though efficient and reliable, cannot replace the basic skills of hepatic surgery: sharp dissection, vascular control and elective sealing.

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What kind of energy devices should be used for laparoscopic liver resection? Recommendations from a systematic review

Scatton

Brustia

Belli

et al. 2015

J Hepatobiliary Pancreat Sci

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Comparison of Clinical Efficacy and Complications Between Laparoscopic Partial and Open Partial Hepatectomy for Liver Carcinoma: A Meta-Analysis

Shang

Bao

Zhang

et al. 2019

Journal of Laparoendoscopic & Advanced Surgical Techniques

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Comparative Short-term Benefits of Laparoscopic Liver Resection

et al. 2016

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This is the largest review of LLR available to date with over 9000 cases published. It confirms growing safety when performed in selected patients and by trained surgeons, and suggests that LLR may offer improved patient short-term outcomes compared with OLR. Improved levels of evidence, standardized reporting of outcomes, and assuring proper training are the next challenges of laparoscopic liver surgery.

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

Abstract: Vapor plasma coagulation using a laparoscopic approach for hepatic resection is a promising new technology that deserves further exploration.

Cited by 4 publications

References 10 publications

What kind of energy devices should be used for laparoscopic liver resection? Recommendations from a systematic review

What kind of energy devices should be used for laparoscopic liver resection? Recommendations from a systematic review

Comparison of Clinical Efficacy and Complications Between Laparoscopic Partial and Open Partial Hepatectomy for Liver Carcinoma: A Meta-Analysis

Comparative Short-term Benefits of Laparoscopic Liver Resection

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