Superficial Pre-coagulation, Sealing and Transection (SPST) method: a bloodless and eco-friendly laparoscopic liver transection technique

Naruhiko Ikoma, MD, Osamu Itano, MD, PhD, Go Oshima, MD, Shinichi Fukuhara, MD, Yuko Kitagawa, MD, PhD

Keio University School of Medicine, University of Texas Health Science Center at Houston

Background: Minimizing blood loss is the important aspect for laparoscopic liver resection. Liver transection is the most challenging part of liver resection, but there is no standard method at present. Here, we have introduced the superficial precoagulation, sealing, and transection (SPST) method, a potentially “bloodless” and “eco-friendly” laparoscopic liver transection technique involving reusable devices: the VIO soft-coagulation system; the VIO BiClamp (bipolar electrosurgical coagulation); Olympus SonoSurg (ultrasonic surgical system); and CUSA (ultrasonic aspirator). Furthermore, we have reported the short-term outcomes of laparoscopic liver transection with the SPST method.

Methods: The study included 14 consecutive patients who underwent laparoscopic partial liver resection with the SPST method at a single institution during August 2008–June 2010.

Results: The median operative time was 201 min (range, 97–332 min) and the median blood loss was 5 mL (range, 5–250 mL). There was no requirement for blood transfusion, no intraoperative complications, and no cases of conversion to open laparotomy. There were no liver transection-related complications such as postoperative bile leakage, bleeding, or infection. All surgical margins were negative, with a mean margin of 4.6 mm, and no local recurrence was observed at an average follow-up of 37.6 months.

Conclusions: The SPST method is a simple, efficient, and cost-effective surgical technique for laparoscopic liver resection. It is associated with low intraoperative blood loss and good short-term outcomes. The SPST method should become a standard technique of laparoscopic liver transection

Session: Poster Presentation

Program Number: ETP073

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