マイクロ波やソフト凝固システムを用いた腹腔鏡下肝切除術の適応拡大

Abstract

Although laparoscopic liver resection has been gradually accepted as a treatment of choice for benign and malignant hepatic diseases, it is necessary to use effective hemostatic device to safety enlarge the indications of laparoscopic liver resection. We have been expanded the use of laparoscopic liver resection by selecting effective hemostatic device: microwave pre-coagulation and soft-coagulation system. In the laparoscopic limited liver resection for the patient with severe liver cirrhosis, we usually use pre-coagulation technique with Microtaze® to control bleeding from the cirrhotic liver. On the other hand, in the laparoscopic anatomical liver resection of non-cirrhotic liver, we use Sonosurg® for the surface of the liver and laparoscopic surgical aspirator and monopolar forceps using soft-coagulation with saline dripping. Selecting proper hemostatic devices based on the conditions of liver is important for safe laparoscopic liver resection.