Aldrighetti Luca, Pulitanò Carlo, Arru Marcella, Catena Marco, Guzzetti Eleonora, Casati Massimiliano, Ferla Gianfranco
Department of Surgery-Liver Unit, Scientific Institute San Raffaele, Vita-Salute San Raffaele University, Via Olgettina, 60, 20132, Milan, Italy.
Am J Surg. 2008 Feb;195(2):270-2. doi: 10.1016/j.amjsurg.2007.02.022.
Parenchymal liver transection represents a fundamental phase of liver surgery. Several devices have been described for safe and careful dissection of the liver parenchyma during laparoscopic liver surgery, but the ideal technique has not yet been defined. This report describes the combined use of ultrasonic dissector and the ultrasonic coagulating cutter for laparoscopic liver resection. The ultrasonic dissector is used to fracture the parenchyma along the line of proposed division, and the uncovered bridging structures are sealed using the ultrasonic coagulating cutter. The combined use of ultrasonic dissector and harmonic scalpel allows liver resection to be safely performed, with the advantage of minimal surgical complication and low blood losses.
肝实质离断是肝脏手术的一个基本阶段。在腹腔镜肝脏手术中，已经有多种器械被用于安全、精细地解剖肝实质，但理想的技术尚未明确。本报告描述了超声刀和超声凝血刀在腹腔镜肝切除术中的联合应用。超声刀用于沿拟切线破碎肝实质，未暴露的桥接结构则用超声凝血刀进行封闭。超声刀和超声切割止血刀的联合使用使肝切除术能够安全进行，具有手术并发症最少和失血少的优点。
