Trends and overall survival after combined liver resection and thermal ablation of colorectal liver metastases: a nationwide population-based propensity score-matched study

de Graaff, Michelle R.; Klaase, Joost M.; den Dulk, Marcel; Coolsen, Marielle M.E.; Kuhlmann, Koert F.D.; Verhoef, Cees; Hartgrink, Henk H.; Derksen, Wouter J.M.; van den Boezem, Peter; Rijken, Arjen M.; Gobardhan, Paul; Liem, Mike S.L.; Leclercq, Wouter K.G.; Marsman, Hendrik A.; van Duijvendijk, Peter; Bosscha, Koop; Elfrink, Arthur K.E.; Manusama, Eric R.; Belt, Eric J. Th.; Doornebosch, Pascal G.; Oosterling, Steven J.; Ruiter, Simeon J.S.; Grünhagen, Dirk J.; Burgmans, Mark; Meijerink, Martijn; Kok, Niels F.M.; Swijnenburg, Rutger-Jan; Buis, Carlijn I.; Hagendoorn, Jeroen; Torrenga, Hans; van Heek, N. Tjarda; Braat, Andries E.; Hoogwater, Frederik J.H.; Consten, Esther C.J.; van der Leij, Christiaan; Patijn, Gijs

doi:10.1016/j.hpb.2023.09.012

HPB

2024

DOI: 10.1016/j.hpb.2023.09.012

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Trends and overall survival after combined liver resection and thermal ablation of colorectal liver metastases: a nationwide population-based propensity score-matched study

Michelle R. de Graaff,

Joost M. Klaase,

Marcel den Dulk

et al.

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Robotic liver parenchymal transection using the SynchroSeal

Pilz da Cunha,

De Meyere,

D’Hondt

et al. 2024

Surg Endosc

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Background There is much heterogeneity in the instrumentation used for parenchymal transection in minimally invasive liver surgery. Instruments specifically designed for robotic parenchymal transection of the liver are lacking. We aim to gain insight into the safety and effectiveness of the SynchroSeal (Intuitive Surgical, Inc., Sunnyvale, CA), a novel bipolar electrosurgical device, in the context of liver surgery. Methods The present study is a post-hoc analysis of prospectively collected data from patients undergoing robotic liver resection (RLR) using the SynchroSeal in two high-volume centres. The results of the SynchroSeal were compared with that of the previous generation bipolar-sealer; Vessel Sealer Extend (Intuitive Surgical, Inc., Sunnyvale, CA) using propensity score matching, after excluding the first 25 Vessel Sealer procedures per center. Results During the study period (February 2020–March 2023), 155 RLRs meeting the eligibility criteria were performed with the SynchroSeal (after implementation in June 2021) and 145 RLRs with the Vessel Sealer. Excellent outcomes were achieved when performing parenchymal transection with the SynchroSeal; low conversion rate (n = 1, 0.6%), small amounts of intraoperative blood loss (median 40 mL [IQR 10–100]), short hospital stays (median 3 days [IQR 2–4]), and adequate overall morbidity (19.4%) as well as severe morbidity (11.0%). In a matched comparison (n = 94 vs n = 94), the SynchroSeal was associated with less intraoperative blood loss (48 mL [IQR 10–143] vs 95 mL [IQR 30–200], p = 0.032) compared to the Vessel Sealer. Other perioperative outcomes were similar between the devices. Conclusion The SynchroSeal is a safe and effective device for robotic liver parenchymal transection.

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Robotic liver parenchymal transection using the SynchroSeal

Pilz da Cunha,

De Meyere,

D’Hondt

et al. 2024

Surg Endosc

View full text Add to dashboard Cite

show abstract

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Trends and overall survival after combined liver resection and thermal ablation of colorectal liver metastases: a nationwide population-based propensity score-matched study

Cited by 1 publication

References 38 publications

Robotic liver parenchymal transection using the SynchroSeal

Robotic liver parenchymal transection using the SynchroSeal

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