Differences between bipolar compression and ultrasonic devices for parenchymal transection during laparoscopic liver resection.
OBJECTIVE
In laparoscopic liver resection, multiple options for parenchymal transection techniques exist; however, none have emerged as superior. The aim of this study was to compare operative characteristics and outcomes between bipolar compression and ultrasonic devices used for parenchymal transection during laparoscopic liver resection.


METHODS
A review of a prospective hepatopancreatobiliary database from December 2002 to August 2009 identified 54 patients who underwent laparoscopic liver resection with parenchymal division using either a bipolar compression (n= 35) or an ultrasonic (n= 19) device. Operative data, histology and 90-day complication rates were compared between the groups using analysis of variance (anova) and Pearson's chi-squared test.


RESULTS
The two groups did not differ significantly in terms of age, body mass index, parenchymal steatosis/inflammation or number of segments resected. A shorter time of parenchymal transection was noted for the bipolar compression device (median: 35 min; range: 20-65 min) vs. the ultrasonic device (median: 55 min; range: 29-75 min) (P < 0.001). Median total operative time was also shorter using the bipolar compression device (130 min) than the ultrasonic device (180 min) (P= 0.050). No significant differences between device groups were noted for estimated blood loss, complications of any type or liver-specific complications.


CONCLUSIONS
Bipolar compression devices may offer advantages over ultrasonic devices in terms of decreased transection time and total operative time. No differences in postoperative complications in laparoscopic liver resection emerged between patients operated using the devices.
Division of Surgical Oncology, Department of Surgery, University of Louisville School of Medicine, 315 East Broadway #312, Louisville, KY 40202, USA.
Nsehniitooh A
NA
Mbah
Russell E
RE
Brown
Matthew R
MR
Bower
Charles R
CR
Scoggins
Kelly M
KM
McMasters
Robert C G
RC
Martin
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D016009:Chi-Square Distribution; D004867:Equipment Design; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D006801:Humans; D007629:Kentucky; D010535:Laparoscopy / Q000009:adverse effects / Q000295:instrumentation*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D011312:Pressure; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D013525:Surgical Instruments; D013997:Time Factors; D016896:Treatment Outcome; D014465:Ultrasonics / Q000295:instrumentation*