The Past and Present of Liver Suture

Abstract

Since the first attempts at resecting parts of diseased livers in the late nineteenth century, hemorrhage has been the main obstacle for surgeons. One of the first hemostasis techniques in liver resection was liver suture. The idea of suturing the liver in order to perform resection was proposed by a team of Russian and Polish surgeons from Kharkiv University in today's Ukraine. The liver suture became widely popular and has been used in various forms throughout the surgical world. Further into the twentieth century, it has lost much of its popularity; however, over more than 100 years of existence it has seen several peaks in interest. Currently, it is still being used by some liver surgeons as it is one of the cheapest ways of obtaining a bloodless liver parenchyma transection.

Polyglutamic Acid‐Based Elastic and Tough Adhesive Patch Promotes Tissue Regeneration through In Situ Macrophage Modulation

“…However, as wound management plays an essential role in numerous medical practices, sutures are insufficient for complex clinical demands, especially for internal organ wounds. For example, sutures and staples may cause additional trauma to surrounding tissue and induce infection in sealing fragile organs such as lung, [ 1 ] liver, [ 1c,2 ] and spleen. [ 3 ] Also, risks of leakages are high when applying sutures or staples to the closure of perforated tissues that demand very tight sealing, such as traumatized stomach [ 4 ] and bladder.…”

Chitosan Lactate Particles for Non-Compression Hemostasis on Hepatic Resection

“…However, these methods can damage surrounding tissues and introduces potential pathological problems to the organ. On the other hand, stitches are often not applicable for diffusive liver injury due to the nature of fragile organ texture and rich blood flow [ 9 , 10 ]. To date, bio-compatible materials loaded with hemostasis agents, such as thrombin/gelatin sponge, showed promising results in hemostasis for severe liver bleeding control [ 11 , 12 , 13 ].…”

Assessment of remnant liver function and volume after selective ligation of portal vein and hepatic artery in a rat model

“…The first liver surgery was performed just over 100 years ago 1 . Considered a complex procedure due to the occurrence mainly of bleeding and biliary fistula, the technique underwent several modifications in this last century 1,2 .…”

“…The first liver surgery was performed just over 100 years ago 1 . Considered a complex procedure due to the occurrence mainly of bleeding and biliary fistula, the technique underwent several modifications in this last century 1,2 . In addition to technical changes, the emergence of energy devices -as monopolar, bipolar and radiofrequency energy -and ultrasonic aspiration, allowed more extensive resections to be performed.…”

“…In addition to technical changes, the emergence of energy devices -as monopolar, bipolar and radiofrequency energy -and ultrasonic aspiration, allowed more extensive resections to be performed. All these advances have brought a new challenge: hepatic failure, which is the most common cause of mortality after extensive respective liver surgeries 1,4 .…”