Use of an Electrothermal Bipolar Vessel Sealing Device During Recipient Hepatectomy for Liver Transplantation

Houben, Philipp; Büchler, Markus W.; Schemmer, Peter

doi:10.1016/j.jamcollsurg.2014.07.941

Cited by 4 publications

(7 citation statements)

References 24 publications

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“…The patient was listed for LT with the intention to perform the current standard pbLT. (3) Hepatectomy with preservation of the recipient IVC was necessary. This was done in a stepwise manner starting with total vascular exclusion achieved by dissecting both the hepatic artery and the portal vein, which were subsequently divided between vascular clips.…”

Section: Patient Technique and Resultsmentioning

confidence: 99%

“…The anterior approach of the IVC allowed for the IVC to be dissected free from the hepatic tissue with the LigaSure (LigaSure ™ Dolphin Tip Open Sealer/Divider, Medtronic Minneapolis, MN), as described elsewhere. (3) Small hepatic veins were closed securely with advanced bipolar energy to allow right hepatectomy after dissection of the right hepatic vein with an endovascular stapler (Endo-GIA ™ Vascular Stapler, Medtronic Minneapolis, MN). Subsequently, left hepatectomy begins at the left hemicircumference of the IVC in the anterior position.…”

Section: Patient Technique and Resultsmentioning

confidence: 99%

“…PbLT is the safest technique for LT, and the modified version by Belghiti has become the standard in our center as in the vast majority of other LT programs. (3) Our novel anterior approach enhancing rapid explantation while preserving the IVC can be used as a safe procedure for giant livers requiring transplantation to achieve the best possible outcomes.…”

Section: Discussionmentioning

confidence: 99%

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Anterior Approach for Hepatectomy Before Piggyback Liver Transplantation in Giant Polycystic Liver Disease

et al. 2020

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Section: Patient Technique and Resultsmentioning

confidence: 99%

Section: Patient Technique and Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Anterior Approach for Hepatectomy Before Piggyback Liver Transplantation in Giant Polycystic Liver Disease

et al. 2020

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“…High-volume LT centers have reported intraoperative BL with average values between 1000 and 2100 ml [ 22 – 24 ]. In our experience, BL during LT could be reduced to about 835 (± 560) ml using LS for recipient hepatectomy [ 11 ].…”

Section: Methodsmentioning

confidence: 99%

“…This may prevent severe bleeding. Furthermore, the sealing device is capable of coping with small liver veins that can be sealed and divided safely without the need for sutures or clips, the latter of which are known for interfering with sufficient “tangential” clamping of the inferior vena cava (IVC) for side-to-side cavocavostomy during piggyback LT [ 11 ]. In 2012, Lamattina et al [ 12 ] reported the use of LS devices for recipient hepatectomy in LT.…”

Section: Introductionmentioning

confidence: 99%

SEALIVE: the use of technical vessel-sealing devices for recipient hepatectomy in liver transplantation: study protocol for a randomized controlled trial

Houben

Khajeh

Hinz

et al. 2018

Trials

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BackgroundThe surgical technique used in liver transplantation has undergone constant evolution in an effort to develop a safe, highly standardized procedure. Despite this, the initial step of recipient hepatectomy has not been the focus of clinical research thus far. Due to advanced coagulopathy in liver transplant recipients, this part of the operation still carries the risk of severe hemorrhage. This trial is designed to compare an electrothermal bipolar vessel sealing device (LigaSure™) and an ultrasound dissector (HARMONIC ACE®+7) with standard surgical techniques during the recipients’ hepatectomy in liver transplantation.Methods/designIn a single-center, prospective, randomized, controlled, parallel, three-armed, confirmatory, open trial, LigaSure™ and HARMONIC ACE®+7 will be compared with standard surgical techniques that use titanium clips and conventional knot-tying ligations during recipient hepatectomy in liver transplantation. Intraoperative total blood loss is the primary endpoint of the trial. Secondary endpoints include blood loss during hepatectomy, the duration of both the hepatectomy and the entire surgical procedure, and blood transfusion requirements of the procedure. To generate reliable data, intraoperative blood loss will be recorded with respect to all rinse fluids during surgery, ascites, and by weighing used swabs. At 80% power and an alpha of 0.025 for both of the experimental groups, 23 subjects will be analyzed per protocol in each study arm in order to detect clinically relevant reduction of intraoperative blood loss. The intention-to-treat analysis will include 69 patients. The follow-up period for each patient will be 90 days for safety reasons, whereas all clinical outcomes will be measured within the first 10 postoperative days.DiscussionTo our knowledge, this is the first prospective, randomized trial comparing two innovative technical methods of vessel sealing and dissection with standard techniques for recipient hepatectomy. This will be done to detect relevant reduction of intraoperative blood loss during liver transplant. The results of the trial are expected to improve patient outcome and safety after liver transplant and to increase the general safety of this procedure.Trial registrationClinicalTrials.gov, NCT 03323242. Registered on October 26, 2017.Electronic supplementary materialThe online version of this article (10.1186/s13063-018-2778-1) contains supplementary material, which is available to authorized users.

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Leber, Gallenblase und Gallenwege

Hoffmann¹,

Schemmer²

2021

Facharztwissen Viszeralchirurgie

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Use of an Electrothermal Bipolar Vessel Sealing Device During Recipient Hepatectomy for Liver Transplantation

Cited by 4 publications

References 24 publications

Anterior Approach for Hepatectomy Before Piggyback Liver Transplantation in Giant Polycystic Liver Disease

Anterior Approach for Hepatectomy Before Piggyback Liver Transplantation in Giant Polycystic Liver Disease

SEALIVE: the use of technical vessel-sealing devices for recipient hepatectomy in liver transplantation: study protocol for a randomized controlled trial

Leber, Gallenblase und Gallenwege

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