An Initial Experience with a New Radiofrequency Vessel Sealer in Laparoscopic Liver Resection

Eren Berber, MD

Cleveland Clinic

Objective: Over the last decade, techniques have been developed for laparoscopic liver resection (LLR). Still, one of the drawbacks is the dependency on multiple different devices for various steps of the procedure. Ideal would be to have a device that could be used to divide and provide hemostasis to the parenchyma, while also serving as a vessel sealer. Herein, we demonstrate a new 5 cm radiofrequency vessel sealing/dividing device (Caiman, Aesculap Inc., Center Vllaey, PA) that combines these features for LLR.

Methods: The device was used in 2 recent LLR cases. The first patient had ocular melanoma metastases in segment 3 and the second patient carcinoid metastases to segment 3.

Results: The first patient underwent laparoscopic left lateral sectionectomy using the Caiman vessel sealer and divider. The operation time was 89 minutes with an unremarkable blood loss. She was discharged home on postoperative day (POD) 2 and her drain was removed on POD 7. Final pathology showed malignant melanoma. The resection margins were free of tumor. The second patient had a laparoscopic segment 3 resection using the device. The operation time was 67 minutes with an unremarkable blood loss. She was discharged home on POD 1. Final pathology showed metastatic neuroendocrine carcinoma with clear resection margins.

Conclusions: Our initial impression is that the new RF vessel sealer has the potential to improve the efficiency of the operation and reduce costs in laparoscopic liver resection, by combining the unique features of a number of instruments that are currently used for a LLR. We are planning to evaluate the utility of this new device in a larger series of LLRs.

Session: Poster Presentation

Program Number: ETP014

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