Laparoscopic hepatectomy using the EnSeal® bipolar sealer

概要

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Application of surgical instruments is an important issue to achieve safe laparoscopic hepatectomy (LH) and further development of minimally invasive surgery. EnSeal® (Ethicon Endo-Surgery, LLC, Cincinnati, OH, USA) is a bipolar tissue sealing device that includes a blade for tissue division. We have used EnSeal® in 22 LHs for 15 patients who had primary or metastatic liver tumor. Procedures of LH were pure laparoscopic procedures in 16 (2 anatomical resections except left lateral sectionectomy, 4 left lateral sectionectomies, 10 partial resections), hand assisted procedure in 4 (4 partial resections) and laparoscopy assisted procedure in 2 (2 partial resections). Mean operative duration was 371.1 minutes, and mean blood loss was 291.5 cc. Average number of clips used was 2.0. However, no clips were used in 63.6% of LHs (14 LHs; 3 left lateral sectionectomies, 11 partial hepatectomies). The average postoperative hospital stay was 7.2 days. No morbidity including bile leakage, or mortality was found. LH using EnSeal® is safe, and can contribute to reducing the usage of surgical clip.