Evaluation of THUNDERBEAT\xae in open liver resection- a single-center experience

Bibek Aryal,Maki Inoue,Daisaku Kamiimabeppu,Teruo Komokata,Mamoru Kaieda,Yutaka Imoto,Kota Yoshikawa,Hiroto Yasumura

doi:10.1186/s12893-018-0423-2

Bibek Aryal, Maki Inoue + Show 6 more

Open Access

https://doi.org/10.1186/s12893-018-0423-2

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Abstract

BackgroundTHUNDERBEAT® (TB) (Olympus Medical Systems Corp., Tokyo, Japan) is a dynamic energy system device that simultaneously delivers ultrasonically generated frictional heat energy and electrically generated bipolar energy. TB is being routinely used in various operative procedures, however, less is known about its utility in liver resection. We, herein, report our early experience of using TB in open liver resection particularly in patients with normal or near-normal liver parenchyma.MethodsWe retrospectively reviewed the clinical characteristics, and evaluated the perioperative outcome of twenty-eight patients who underwent liver resection with TB, and twenty-four patients who underwent liver resection with basic procedure in our institution. The resection type was stratified into: major hepatectomy; resection of 3 or more than 3 Couinauds segments, and minor hepatectomy; resection of less than 3 Couinauds segments.ResultsLiver resection time (mean ± SD) in TB group with major hepatectomy was significantly shorter: 16.7 ± 8.8 compared to 62.8 ± 39.4 min in basic procedure group (P < 0.0001). Accordingly, the liver resection time (mean ± SD) in TB group with minor hepatectomy was also significantly shorter, 8.3 ± 2.9 min compared to 45.2 ± 23.9 min in liver resection with basic procedure (P < 0.001). No significant difference was observed between the groups in terms of intraoperative blood transfusion ratio, postoperative complication and postoperative liver dysfunction.ConclusionTB as a new energy device can offer a safe, reliable and substantially rapid liver resection particularly in patients with normal or near-normal liver parenchyma.

Highlights

THUNDERBEAT® (TB) (Olympus Medical Systems Corp., Tokyo, Japan) is a dynamic energy system device that simultaneously delivers ultrasonically generated frictional heat energy and electrically generated bipolar energy
Most of the patients were diagnosed with HCC, followed by metastatic colorectal cancer, perihilar or intra-hepatic cholangiocellular carcinoma (CCC), gallbladder cancer (GB Ca) and a few other lesions
Liver resection time in TB group with major hepatectomy was significantly shorter than the patients who underwent liver resection with basic procedure (16.7 ± 8.83 vs. 62.8 ± 39.4 min; P < 0.0001)

Summary

Introduction

THUNDERBEAT® (TB) (Olympus Medical Systems Corp., Tokyo, Japan) is a dynamic energy system device that simultaneously delivers ultrasonically generated frictional heat energy and electrically generated bipolar energy. A majority of liver resections performed these days involves the use of some energy device for cutting, coagulation or sealing, such as Cavitron Ultrasonic Surgical Aspirator (CUSA, Tyco Healthcare, Mansfield, MA, USA), the Harmonic Scalpel (Ethicon Endo-Surgery, Cincinnati, OH, USA), the Ligasure Vessel Sealing System (Covidien, Mansfield, MA, USA) and several other dissecting sealers [1–8]. THUNDERBEAT® (TB) (Olympus Medical Systems Corp., Tokyo, Japan) is the first device to simultaneously integrate ultrasonically generated frictional heat energy and electrically generated bipolar energy [9]. The ultrasonic technology is used for rapid cutting and precise dissection while the bipolar technology performs reliable vessel sealing. TB is considered vibrant due to its ability to gain a rapid surge in temperature with minimal thermal spreading [9]

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