Analysis of laparoscopic laser liver resection in standardized porcine model
| Autor: | Markus Kleemann, Heike Wolken, Dirk Theisen-Kunde, Christiane Kuempers, Tobias Keck, David Benjamin Ellebrecht |
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| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
Carcinoma Hepatocellular Swine 03 medical and health sciences Liver Neoplasms Experimental 0302 clinical medicine Hematoma Internal medicine Biopsy medicine Animals Hepatectomy medicine.diagnostic_test business.industry Ultrasound Granulation tissue Hepatology medicine.disease Surgery Coagulative necrosis medicine.anatomical_structure 030220 oncology & carcinogenesis Hepatocellular carcinoma Hemostasis Laparoscopy 030211 gastroenterology & hepatology Laser Therapy business |
| Zdroj: | Surgical Endoscopy. 32:4966-4972 |
| ISSN: | 1432-2218 0930-2794 |
| DOI: | 10.1007/s00464-018-6258-1 |
| Popis: | Hepatocellular carcinoma is a highly prevalent and lethal primary neoplasia of the liver and metastases of other malignancies affect most frequently the liver. Minimally invasive surgical approach for liver resections is advancing. Dissection of liver parenchyma by laparoscopic technique remains challenging and new technologies are in need. Therefore, we asked whether it is feasible to dissect liver tissue comparably in terms of speed and hemostasis with a non-contact 1.9-µm cw-laser device and whether there are differences in the postoperative healing process compared to a gold standard device (ultrasound aspirator) in an experimental model. Laparoscopic laser and ultrasound aspirator standardized partial liver resections were performed in seven pigs. Resection time, hemostasis time, and blood loss were evaluated. After at least 10 days, representative specimen of the resection areas was collected via re-laparoscopy and biopsy and side effects like hematoma, abscess, or bilioma were noted. Histologically, coagulation necrosis margin, granulation tissue zone, tissue fibrosis, and giant cell count were analyzed. Laparoscopic laser liver resection was three times faster compared to the laparoscopic ultrasound aspirator. Blood loss was equal in both groups. No side effects like hematoma or bilioma occurred. Histologically, specimen showed the same expansion of coagulation necrosis zone and granulation tissue. Fibrotic scar could be determined in three cases in both groups, respectively. However, giant cell count was significant higher in the laser resection group. The 1.9-µm cw-laser device enables a safe and fast liver resection in an experimental pig model compared to a gold standard (ultrasound aspirator) laparoscopic liver resection method. Wound healing is not interfered by laser liver resection. |
| Databáze: | OpenAIRE |
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