Use of a cavitron ultrasonic surgical aspirator for parenchyma‐sparing and complex liver resections in dogs

Abstract

Objective: To report the clinical use of a cavitron ultrasonic surgical aspirator (CUSA) for the resection of hepatic lesions in dogs. Study design: Clinical prospective study.Animals: Eleven client-owned dogs. Methods: Dogs requiring a hepatic nodulectomy, segmentectomy, and/or a lobectomy (including complex lobectomies) were enrolled. The number and location of procedures, blood loss, duration of surgery, and short-term complications were recorded.Results: Dogs underwent a mean of 2.3 ± 1.1 procedures. All masses were amenable to surgical excision regardless of their location and their relationship with major hepatic vessels. Dogs lost a median of 77 mL of blood (9.9-161), which corresponded to 4.3% of blood volume (0.8%-23.2%). The dog with the highest blood loss survived without requiring transfusion. The median duration of all CUSA procedures was 33.5 minutes (15-82). Short-term outcomes were assessed for the first 15 days, during which two complications were diagnosed. Cholangiohepatitis was diagnosed in one dog and resolved after medical management, and another dog developed necrotic pancreatitis and died.Conclusion: Liver parenchyma-sparing nodulectomies and segmentectomies and liver lobectomies including complex lobectomies were achieved with a CUSA in all dogs.Clinical significance: Use of a CUSA can be considered as an alternative for the removal of hepatic lesions in dogs.

LigaSure versus monopolar cautery for recipient hepatectomy in liver transplantation: a propensity score-matched analysis

“…Therefore, several randomized controlled trials have been conducted to evaluate the clinical benefits of different liver transection methods in open liver resection. To date, several animal studies have been shown to compare the safety and effectiveness of Cavitron ultrasonic surgical aspirator (CUSA), LigaSure energy device, and ultrasonic shears for laparoscopic liver parenchymal transection (17,20).…”

“…The use of energy-based devices such as LigaSure and ultrasonic sear in liver surgery has been focused on laparoscopic liver parenchymal dissection. In several studies, liver parenchymal dissection takes longer than CUSA, but it has been reported that there is no difference in bleeding or surgical outcomes (17,18). However, reviews on the role of energy-based devices in LT at a high risk of bleeding are still insufficient (19).…”

Surgical removal of an orbital liposarcoma in a dog using the cavitron ultrasonic surgical aspirator

“…The CUSA handpiece resembles a phacoemulsification machine; its angulated tip diameters measure 3–4 mm, which allows access to very narrow spaces 7 . In veterinary medicine, CUSA was mainly previously utilised for the removal of parenchyma‐sparing and complex liver 8 and brain neoplasia 9,10 . In human medicine, a surgical aspirator has been used successfully in orbital decompression, lacrimal surgery and orbital tumour surgery 11–14 …”