The multimodal water jet dissector--a technology for laparoscopic liver surgery.
In order to avoid laparotomy in patients with superficially and/or anatomically favourably located liver lesions, the feasibility of laparoscopic liver resection using an aqua jet was evaluated in 6 pigs. For this purpose a commercially available water jet dissector was adapted for laparoscopic use and modified to a multifunctional device providing aqua jet, suction and cautery. To improve laparoscopic vision during jet activity a hydrolaparoscope was used. The left lateral lobe was resected using clips for haemostasis only.


RESULTS
All animals (34-55 kg, average 41 kg) survived the procedure. The blood loss at operation consisted of 225 ml (50-600 ml), the haematocrit 3.3% (1-8%). No bleeding or other complications were encountered postoperatively. The average weight of the specimens was 201 g (120-289 g).


CONCLUSIONS
Laparoscopic liver resection using an aqua jet is feasible. Safe haemostasis can be achieved with clips if the vessels are entirely freed with the jet before clipping.
Schöb
O M
OM
Clinic of Visceral Surgery, University of Zürich Hospital, Switzerland.
Schlumpf
R B
RB
Uhlschmid
G K
GK
Rausis
C
C
Spiess
M
M
Largiadèr
F
F
D000818:Animals; D004210:Dissection / Q000295:instrumentation*; D004867:Equipment Design; D005260:Female; D006488:Hemostasis, Surgical; D006498:Hepatectomy / Q000295:instrumentation* / Q000379:methods; D020706:Laparoscopes; D010535:Laparoscopy / Q000379:methods; D008107:Liver Diseases / Q000601:surgery; D013552:Swine