Comparison of 5 surgical techniques for partial liver lobectomy in the dog for intraoperative blood loss and surgical time

Publication date 29th July 2010
Authors Marije Risselada, Gary W Ellison, Nicholas J. Bacon, Maximilian MR Polyak, Jim Van Gilder, Kristin Kirkby, Stanley E Kim

Objective

To compare surgical time and intraoperative blood loss for 5 partial liver lobectomy techniques in the dog

Study design

Experimental in vivo study.

Animals

Dogs (n=10).

Methods

Five surgical techniques (SurgiTie™; LigaSure™; Ultracision® Harmonic Scalpel [UAS]; Suction+Clip; Suction+thoracoabdominal stapler [TA]) for partial liver lobectomy in dogs were evaluated and compared for total surgical time and intraoperative blood loss. Body weight, activated clotting time (ACT), heart rate, and intraoperative blood pressure (BP) were recorded. Blood loss was determined by adding the weight of the blood soaked sponges during surgery (1 g=1 mL) to the amount of suctioned blood (mL). Surgical time (in seconds) was determined from the start of the lobectomy until cessation of bleeding from the stump. Mean surgical time and mean blood loss for each technique were compared using a Tukey's multiple comparison test.

Results

No significant differences were found between dogs for weight, ACT, heart rate, and intraoperative BP. No complications were seen with the SurgiTie™ technique in 9 of 10 cases. There was no significant difference in surgical time between techniques however there was a significant difference for blood loss; the Suction+Clip method had significantly more blood loss than the other techniques.

Conclusion

Skeletonization of the lobar vessels before individually clipping them (Suction+Clip) resulted in a higher blood loss than using Suction+TA, UAS, SurgiTie™ or the LigaSure™ device. The SurgiTie™ appears to be an acceptable method for partial liver lobectomy.

Clinical relevance

Although skeletonization and individually clipping the vessels had the highest blood loss, it still was