title: Evaluation of a newly developed piezo actuator-driven pulsed water jet system for liver resection in a surviving swine animal model.
abstract: BACKGROUND
  Preservation of the hepatic vessels while dividing the parenchyma is key to achieving safe liver resection in a timely manner. In this study, we assessed the feasibility of a newly developed, piezo actuator-driven pulsed water jet (ADPJ) for liver resection in a surviving swine model.
  
  
  METHODS
  Ten domestic pigs underwent liver resection. Parenchymal transection and vessel skeletonization were performed using the ADPJ (group A, n = 5) or an ultrasonic aspirator (group U, n = 5). The water jet was applied at a frequency of 400 Hz and a driving voltage of 80 V. Physiological saline was supplied at a flow rate of 7 ml/min. After 7 days, the animals were killed and their short-term complications were examined and compared between the two groups.
  
  
  RESULTS
  No significant complications, such as massive bleeding, occurred in either group during the surgical procedures. The transection time per transection area was significantly shorter in group A than in group U (1.5 ± 0.3 vs. 2.3 ± 0.5 min/cm(2), respectively, P = 0.03). Blood loss per transection area was not significantly different between groups A and U (9.3 ± 4.2 vs. 11.7 ± 2.3 ml/cm(2), P = 0.6). All pigs in group A survived for 7 days. No postoperative bleeding or bile leakage was observed in any animal at necropsy.
  
  
  CONCLUSIONS
  The present results suggested that the ADPJ reduces transection time without increasing blood loss. ADPJ is a safe and feasible device for liver parenchymal transection.
authors.affiliation: Division of Advanced Surgical Science and Technology, Graduate School of Medicine, Tohoku University, 1-1 Seiryou-machi, Aobaku, Sendai, 980-8574, Japan. chikashi-n@med.tohoku.ac.jp.
authors.forename: Chikashi
authors.initials: C
authors.lastname: Nakanishi
authors.affiliation: Division of Advanced Surgical Science and Technology, Graduate School of Medicine, Tohoku University, 1-1 Seiryou-machi, Aobaku, Sendai, 980-8574, Japan. torun@med.tohoku.ac.jp.
authors.forename: Toru
authors.initials: T
authors.lastname: Nakano
authors.affiliation: Department of Neurosurgery, Graduate School of Medicine, Tohoku University, 1-1 Seiryou-machi, Aobaku, Sendai, 980-8574, Japan. nakg_neurosurg@yahoo.co.jp.
authors.forename: Atsuhiro
authors.initials: A
authors.lastname: Nakagawa
authors.affiliation: Division of Advanced Surgical Science and Technology, Graduate School of Medicine, Tohoku University, 1-1 Seiryou-machi, Aobaku, Sendai, 980-8574, Japan. ode813@yahoo.co.jp.
authors.forename: Chiaki
authors.initials: C
authors.lastname: Sato
authors.affiliation: Division of Advanced Surgical Science and Technology, Graduate School of Medicine, Tohoku University, 1-1 Seiryou-machi, Aobaku, Sendai, 980-8574, Japan. aiko_mount@yahoo.co.jp.
authors.forename: Masato
authors.initials: M
authors.lastname: Yamada
authors.affiliation: Division of Advanced Surgical Science and Technology, Graduate School of Medicine, Tohoku University, 1-1 Seiryou-machi, Aobaku, Sendai, 980-8574, Japan. kawan@med.tohoku.ac.jp.
authors.forename: Naoki
authors.initials: N
authors.lastname: Kawagishi
authors.affiliation: Department of Neurosurgery, Graduate School of Medicine, Tohoku University, 1-1 Seiryou-machi, Aobaku, Sendai, 980-8574, Japan. tomi@nsg.med.tohoku.ac.jp.
authors.forename: Teiji
authors.initials: T
authors.lastname: Tominaga
authors.affiliation: Division of Advanced Surgical Science and Technology, Graduate School of Medicine, Tohoku University, 1-1 Seiryou-machi, Aobaku, Sendai, 980-8574, Japan. noriaki-ohuchi@med.tohoku.ac.jp.
authors.forename: Noriaki
authors.initials: N
authors.lastname: Ohuchi
mesh_terms: D000818:Animals; D002712:Chlorides / Q000097:blood; D004560:Electricity; D004573:Electrolytes / Q000097:blood; D005240:Feasibility Studies; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects / Q000295:instrumentation*; D007432:Intraoperative Period; D008099:Liver / Q000601:surgery*; D008297:Male; D012964:Sodium / Q000097:blood; D013552:Swine; D014867:Water
chemical_list: D002712:Chlorides; D004573:Electrolytes; D014867:Water; D012964:Sodium
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