title: Choice of device for parenchymal transection in laparoscopic hepatectomy.
abstract: BACKGROUND
  Laparoscopic hepatic surgery has only recently become an established field. Technological limitations in devices used to transect the liver parenchyma and control hemostasis have been a rate limiting step. However, as a result of advances in products specifically tailored to liver surgery, there has been steady progress in the complexity of laparoscopic hepatectomies performed, from the minimally invasive fenestration of liver cysts, to peripheral wedge resections, major hepatectomy, and recently donor hepatectomy. Herein, we discuss the role of several laparoscopic devices which include the endoscopic stapler, pre-coagulators, ultrasonic dissector, ultrasonic shears, and vessel sealing devices.
  
  
  CONCLUSIONS
  Laparoscopic liver surgery introduces new challenges to even the experienced surgeon. It is important to have a solid understanding of the advantages and limitations of available instruments in order to safely and effectively expand the use of laparoscopy in hepatic surgery.
authors.affiliation: Mount Sinai School of Medicine, New York, NY, USA.
authors.forename: Umut
authors.initials: U
authors.lastname: Sarpel
authors.forename: Diego M
authors.initials: DM
authors.lastname: Ayo
authors.forename: Elliot
authors.initials: E
authors.lastname: Newman
mesh_terms: D002425:Cautery / Q000295:instrumentation*; D004867:Equipment Design; D019544:Equipment Failure Analysis; D006488:Hemostasis, Surgical / Q000295:instrumentation*; D006498:Hepatectomy / Q000295:instrumentation*; D020706:Laparoscopes; D013537:Sutures; D013673:Technology Assessment, Biomedical; D059708:Ultrasonic Surgical Procedures / Q000295:instrumentation*