Impact of the CUSA and Operative Ultrasound on Hepatic Resection

Author:

Little J. M.12,Hollands M. J.1

Affiliation:

1. Department of Surgery, Westmead Hospital, and The University of Sydney, Australia

2. Department of Surgery, Westmead Hospital, Westmead, N.S.W. 2145, Australia

Abstract

New technologies have been developed for liver surgery, and, like all new technologies, they have a glamour which makes them seem desirable. There is an understanding abroad that they make liver surgery easier and open up the field to those without special training. But there is no proof that the new devices are in any way cost-effective, and certainly no proof that liver surgery has become safer since their advent. Fifty consecutive elective liver resections have been studied, almost half performed with the aid of the ultrasonic dissector and aspirator and diagnostic intraoperative ultrasound. There was no mortality in the whole group, but a 24% morbidity. Operative diagnostic ultrasound was thought to allow more precise planning of surgery. Its use was not associated with any increase in operative time, nor was there any increase in postoperative morbidity. The ultrasonic dissector and aspirator improved technique, reflected in a lower blood loss for each case, in fewer transfusions required, in a shorter postoperative hospital stay and in an ability to achieve these benefits in older patients. Neither device could be said to offer an entree to instant liver surgery. The use of the two devices apparently offered savings measured by a fall in the median postoperative hospital stay of 4.5 days, by a saving of 700 mls in median blood requirement and by a fall in transfusion rate from 64% to 9%.

Publisher

Hindawi Limited

Subject

Hepatology,Surgery

Cited by 23 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

1. The CUSA Clarity Soft Tissue Removal Study: Clinical Performance Investigation of the CUSA Clarity Ultrasonic Surgical Aspirator System for Soft Tissue Removal During Liver Surgery;Journal of Laparoendoscopic & Advanced Surgical Techniques;2024-02-01

2. Getting going: Incorporating ultrasound into an HPB practice;Surgery Open Science;2022-04

3. Segment-oriented anatomic liver resections;Blumgart's Surgery of the Liver, Biliary Tract and Pancreas, 2-Volume Set;2017

4. Cavitron Ultrasonic Surgical Aspirator;The SAGES Manual on the Fundamental Use of Surgical Energy (FUSE);2012

5. Segment-oriented anatomic liver resections;Blumgart's Surgery of the Liver, Pancreas and Biliary Tract;2012

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