A novel liver parenchyma transection technique using locking straight rigid ties. An experimental study in pigs.
BACKGROUND
Technological advances have led to the development of many devices used in liver resections. However, no single transection tool is uniformly considered to be better than the others. This study aimed to develop an effective, fast, and cost-efficient technique for hepatic parenchymal transection.


METHODS
A liver parenchyma compression device in the form of a locking straight rigid tie (LoStRiT) was newly developed. Twelve pigs were distributed into two groups. The control group ( n = 6) comprised animals that underwent hepatectomy using the standard Kelly-clysis technique. The study group (n = 6) comprised animals that underwent hepatectomy using sequential LoStRiT mechanisms. The transection speed, blood loss, and biloma formation were recorded.


RESULTS
The mean parenchymal transection speed was 1.27 ± 0.27 cm(2)/min for the control group and 2.39 ± 0.56 cm(2)/min for the LoStRiT group ( p = .003). The mean blood loss per kilogram of body weight was 9.8 ± 5.2 ml/kg for the control group and 3.9 ± 0.9 ml/kg for the LoStRiT group ( p = .040). No bilomas were identified.


CONCLUSIONS
LoStRiT hepatectomy appears to be effective, fast, and reproducible in a porcine model of liver resection. Further development of this novel and potentially cost-efficient technique includes construction of the device using absorbable materials.
Hepato-Pancreato-Biliary & Transplant Division, Department of Surgery, McGill University , Montreal, QC , Canada.
Dionisios
D
Vrochides
Dimitrios
D
Kardassis
Achilleas
A
Ntinas
Dimosthenis
D
Miliaras
Apostolos
A
Papalois
Evangelos
E
Magnissalis
Peter
P
Metrakos
D000818:Animals; D016063:Blood Loss, Surgical; D005260:Female; D006488:Hemostasis, Surgical / Q000379:methods*; D006498:Hepatectomy / Q000295:instrumentation* / Q000379:methods; D023421:Models, Animal; D034421:Sus scrofa