Differences between bipolar compression and ultrasonic devices for parenchymal transection during laparoscopic liver resection

Abstract

ObjectivesIn laparoscopic liver resection, multiple options for parenchymal transection techniques exist; however, none have emerged as superior. The aim of this study was to compare operative characteristics and outcomes between bipolar compression and ultrasonic devices used for parenchymal transection during laparoscopic liver resection. MethodsA review of a prospective hepatopancreatobiliary database from December 2002 to August 2009 identified 54 patients who underwent laparoscopic liver resection with parenchymal division using either a bipolar compression (n= 35) or an ultrasonic (n= 19) device. Operative data, histology and 90-day complication rates were compared between the groups using analysis of variance (anova) and Pearson's chi-squared test. ResultsThe two groups did not differ significantly in terms of age, body mass index, parenchymal steatosis/inflammation or number of segments resected. A shorter time of parenchymal transection was noted for the bipolar compression device (median: 35min; range: 20–65min) vs. the ultrasonic device (median: 55min; range: 29–75min) (P < 0.001). Median total operative time was also shorter using the bipolar compression device (130min) than the ultrasonic device (180min) (P= 0.050). No significant differences between device groups were noted for estimated blood loss, complications of any type or liver-specific complications. ConclusionsBipolar compression devices may offer advantages over ultrasonic devices in terms of decreased transection time and total operative time. No differences in postoperative complications in laparoscopic liver resection emerged between patients operated using the devices.