title: Two-surgeon technique using saline-linked electric cautery and ultrasonic surgical aspirator in living donor hepatectomy: its safety and efficacy.
abstract: BACKGROUND
  Saline-linked electric cautery (SLC) is introduced as an effective device to reduce blood loss in liver surgery. The aim of the current study was to evaluate the safety and efficacy of a 2-surgeon technique using SLC and the Cavitron Ultrasonic Surgical Aspirator (CUSA; Valleylab, Boulder, CO) in living donor hepatectomy.
  
  
  METHODS
  Forty-three living donor right hepatectomy cases were enrolled in this study. The first 28 cases underwent liver transection with CUSA alone (CUSA group), while additional SLC was applied in the current 15 cases (2-surgeon technique, TS group).
  
  
  RESULTS
  Blood loss was significantly reduced by the 2-surgeon technique (1,115.2 +/- 652.9 g in CUSA group vs 732.3 +/- 363.6 g in TS group, P < .05). In the TS group, there was no bile leakage from the cut surface. The early graft function and postoperative recipient survival were not significantly different between the groups.
  
  
  CONCLUSIONS
  According to our single-center experience, blood loss and donor complications in living donor hepatectomies were significantly reduced using a 2-surgeon technique using CUSA and SLC, while maintaining the graft viability.
authors.affiliation: Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan. takapon@net.nagasaki-u.ac.jp
authors.forename: Mitsuhisa
authors.initials: M
authors.lastname: Takatsuki
authors.forename: Susumu
authors.initials: S
authors.lastname: Eguchi
authors.forename: Kosho
authors.initials: K
authors.lastname: Yamanouchi
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Tokai
authors.forename: Masaaki
authors.initials: M
authors.lastname: Hidaka
authors.forename: Akihiko
authors.initials: A
authors.lastname: Soyama
authors.forename: Kensuke
authors.initials: K
authors.lastname: Miyazaki
authors.forename: Koji
authors.initials: K
authors.lastname: Hamasaki
authors.forename: Yoshitsugu
authors.initials: Y
authors.lastname: Tajima
authors.forename: Takashi
authors.initials: T
authors.lastname: Kanematsu
mesh_terms: D000328:Adult; D002425:Cautery; D005260:Female; D006488:Hemostasis, Surgical / Q000295:instrumentation; D006498:Hepatectomy / Q000295:instrumentation* / Q000379:methods; D006801:Humans; D016031:Liver Transplantation; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D014464:Ultrasonic Therapy / Q000295:instrumentation