A novel technique for parenchymal division during hepatectomy

The major complication in the performance of hepatic rectional surgery is hemorrhage. This report describes a novel technique to achieve hepatic parenchymal division. Preliminary use of the ultrasonic dissector results in the fracture of hepatocytes and leaves bridging arteries, veins, and ducts intact. The use of the Ligasure clamp heat-seals these bridging structures, allowing their bloodless transection with surgical scissors. Six consecutive liver resections were performed in this fashion. The range of blood loss was 425 to 700 mL. This paper describes a simple technique to achieve rapid safe parenchymal division of the liver during hepatectomy resulting in minimal blood loss.