Comparison of liver parenchymal ablation and tissue necrosis in a cadaveric bovine model using the Harmonic Scalpel™, the LigaSure™, the Cavitron Ultrasonic Surgical Aspirator® and the Aquamantys® devices

Abstract

ObjectivesThe amount of tissue that is ablated or necrosed at the line of parenchymal transection is of clinical significance in the interpretation of resection margin status following hepatic resection. The aim of this study was to define the extent of parenchymal ablation and necrosis in liver tissue using the Harmonic Scalpel™, the LigaSure™, the Cavitron Ultrasonic Surgical Aspirator® (CUSA®) and the Aquamantys® dissector ex vivo. MethodsMounted blocks of non‐perfused bovine liver were transected using the Harmonic Scalpel™, LigaSure™, CUSA® and Aquamantys® devices. Outcome measures included parenchymal ablation (ablation band widths and weights) and tissue necrosis band widths along the line of transection. Each experiment was replicated five times. ResultsAll devices were associated with parenchymal ablation (Harmonic Scalpel™, 4.73 ± 1.62 mm; LigaSure™, 4.55 ± 2.02 mm; CUSA®, 7.16 ± 2.87 mm; Aquamantys®, 4.75 ± 1.43 mm) and tissue necrosis (Harmonic Scalpel™, 1.07 ± 0.46 mm; LigaSure™, 1.36 ± 0.36 mm; CUSA®, 0.81 ± 0.21 mm; Aquamantys®, 0.81 ± 0.36 mm). ConclusionsThe Harmonic Scalpel™, LigaSure™, CUSA® and Aquamantys® devices were associated with bands of tissue loss along the hepatic parenchymal transection line in this benchtop cadaveric model. This should be taken into account in the interpretation of resection margin status following liver resection.