title: A novel method using the VIO soft-coagulation system for liver resection.
abstract: BACKGROUND
  The VIO soft-coagulation system (SCS) is a new device for tissue coagulation. The current study evaluated the efficacy of the SCS when used for liver resection.
  
  
  METHODS
  The 252 patients were divided into 2 groups; in 155 patients (conventional group), liver transection was performed using an ultrasonic dissector and saline-coupled bipolar electrocautery for hemostasis. In 97 patients (SCS group), the SCS was used instead of bipolar electrocautery.
  
  
  RESULTS
  The median blood loss and surgical time were less in the SCS group than in the conventional group (350 vs 640 mL, P = .0028; 280 vs 398 min, P < .0001). No significant differences were found in postoperative complications between the SCS group (32.0%) and the conventional group (40.6%). The risk factors for bleeding were nonuse of the SCS (P = .0039), macroscopic vascular invasion of the hepatic tumors (P = .0088), and collagen type IV value in the sera >200 (P = .0250) on multivariate analysis. In a subgroup analysis, in the collagen type IV value >200 subgroup, the tumor diameter >5 cm subgroup, and the inflow nonocclusion subgroup, use of the SCS decreased surgical bleeding (P = .0120, P = .0126, and P = .0032, respectively) and surgical time (P = .0001, P < .0001, and P = .0036, respectively) compared with the conventional group. Furthermore, even in the major hepatectomy group, the SCS use decreased surgical time (P < .0001).
  
  
  CONCLUSIONS
  The SCS is an effective and safe device for decreasing surgical time and surgical bleeding without increasing the rate of bile leakage and causing other complications.
authors.affiliation: Department of General and Gastroenterological Surgery, Osaka Medical College, Osaka, Japan. sur122@poh.osaka-med.ac.jp
authors.forename: Fumitoshi
authors.initials: F
authors.lastname: Hirokawa
authors.forename: Michihiro
authors.initials: M
authors.lastname: Hayashi
authors.forename: Yoshiharu
authors.initials: Y
authors.lastname: Miyamoto
authors.forename: Mitsuhiko
authors.initials: M
authors.lastname: Iwamoto
authors.forename: Ichiro
authors.initials: I
authors.lastname: Tsunematsu
authors.forename: Mitsuhiro
authors.initials: M
authors.lastname: Asakuma
authors.forename: Tetsunosuke
authors.initials: T
authors.lastname: Shimizu
authors.forename: Koji
authors.initials: K
authors.lastname: Komeda
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Inoue
authors.forename: Nobuhiko
authors.initials: N
authors.lastname: Tanigawa
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical / Q000517:prevention & control; D004564:Electrocoagulation; D005260:Female; D006488:Hemostasis, Surgical / Q000295:instrumentation*; D006498:Hepatectomy / Q000295:instrumentation*; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D013997:Time Factors