Abstract
In today’s surgery, staplers are standard instruments in many laparoscopic and open procedures. In liver surgery, staplers can be used for dissection of hepatic vessels and for transection of liver parenchyma. Stapler hepatectomy is a cost-effective method of parenchymal transection of the liver with morbidity and mortality comparable to other techniques in liver surgery; the indications for stapler hepatectomy are comparable to general indications for both anatomical and atypical liver resections. Reliable and fast tissue transection is combined with low blood loss and shorter operative time. This can only be achieved when staplers and other modern surgical devices such as argon-beam and mono- or bipolar electrocoagulation and anesthesiological concepts to achieve low central venous pressure are combined. In this chapter, technique and anesthesiological concepts needed are described.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Sugarbaker DJ, Mentzer SJ (1992) Improved technique for hilar vascular stapling. Ann Thorac Surg 53:165–166
Nanashima A, Sumida Y, Oikawa M, Murakami G, Abo T, Hidaka S, Takeshita H, Sawai T, Nagayasu T (2009) Vascular transection using endovascular stapling in hepatic resection. Hepatogastroenterology 56:498–500
Fong Y, Blumgart LH (1997) Useful stapling techniques in liver surgery. J Am Coll Surg 185:93–100
Lefor AT, Flowers JL (1994) Laparoscopic wedge biopsy of the liver. J Am Coll Surg 178:307–308
Trede M (1993) Use of a laparoscopic disposable surgical stapler in liver resection. Chirurg 64:406–407
Zilling T, Walther BS, Holmin T (1990) Segmental liver resection with linear stapling device. An experimental study on pigs. In Vivo 4:273–275
Schemmer P, Bruns H, Weitz J, Schmidt J, Büchler M (2008) Liver transection using vascular stapler: a review. HPB (Oxford) 10:249–252
Schemmer P, Friess H, Dervenis C, Schmidt J, Weitz J, Uhl W, Büchler M (2007) The use of endo-GIA vascular staplers in liver surgery and their potential benefit: a review. Dig Surg 24:300–305
Schemmer P, Friess H, Hinz U, Mehrabi A, Kraus T, Z’graggen K, Schmidt J, Uhl W, Büchler M (2006) Stapler hepatectomy is a safe dissection technique: analysis of 300 patients. World J Surg 30:419–430
Poon R (2007) Current techniques of liver transection. HPB (Oxford) 9:166–173
Reddy S, Barbas A, Gan T, Hill S, Roche A, Clary B (2008) Hepatic parenchymal transection with vascular staplers: a comparative analysis with the crush-clamp technique. Am J Surg 196:760–767
Wang W, Fan S (2003) Use of the Endo-GIA vascular stapler for hepatic resection. Asian J Surg 26:193–196
Shah A, Callaway M, Thomas M, Finch-Jones M (2010) Contrast-enhanced intraoperative ultrasound improves detection of liver metastases during surgery for primary colorectal cancer. HPB (Oxford) 12:181–187
Li J, Malago M, Sotiropoulos G, Lang H, Schaffer R, Paul A, Broelsch C, Nadalin S (2009) Intraoperative application of “white test” to reduce postoperative bile leak after major liver resection: results of a prospective cohort study in 137 patients. Langenbecks Arch Surg 394:1019–1024
Nadalin S, Li J, Lang H, Sotiropoulos G, Schaffer R, Radtke A, Saner F, Broelsch C, Malago M (2008) The White test: a new dye test for intraoperative detection of bile leakage during major liver resection. Arch Surg 143:402–404 (discussion 404)
Chen X, Qiu F (2008) A simple technique ligating the corresponding inflow and outflow vessels during anatomical left hepatectomy. Langenbecks Arch Surg 393:227–230 (discussion 231–234)
Elias D, Dube P, Bonvalot S, Debanne B, Plaud B, Lasser P (1998) Intermittent complete vascular exclusion of the liver during hepatectomy: technique and indications. Hepatogastroenterology 45:389–395
Wu C, Yeh D, Ho W, Yu C, Cheng S, Liu T, P’eng F (2002) Occlusion of hepatic blood inflow for complex central liver resections in cirrhotic patients: a randomized comparison of hemihepatic and total hepatic occlusion techniques. Arch Surg 137:1369–1376
Rahbari NN, Zimmermann JB, Koch M, Bruckner T, Schmidt T, Elbers H, Reissfelder C, Weigand MA, Büchler MW, Weitz J (2009) IVC CLAMP: infrahepatic inferior vena cava clamping during hepatectomy—a randomised controlled trial in an interdisciplinary setting. Trials 10:94
Rahbari NN, Wente MN, Schemmer P, Diener MK, Hoffmann K, Motschall E, Schmidt J, Weitz J, Büchler MW (2008) Systematic review and meta-analysis of the effect of portal triad clamping on outcome after hepatic resection. Br J Surg 95:424–432
Balaa FK, Gamblin TC, Tsung A, Marsh JW, Geller DA (2008) Right hepatic lobectomy using the staple technique in 101 patients. J Gastrointest Surg 12:338–343
Jarnagin WR, Gonen M, Fong Y, DeMatteo RP, Ben-Porat L, Little S, Corvera C, Weber S, Blumgart LH (1803) Improvement in perioperative outcome after hepatic resection. Analysis of,consecutive cases over the past decade. Ann Surg 2002(236):397–407
Scheele J, Stangl R, Altendorf-Hofmann A, Paul M (1995) Resection of colorectal liver metastases. World J Surg 19:59–71
Fan ST, Lo CM, Liu CL, Lam CM, Yuen WK, Yeung C, Wong J (1999) Hepatectomy for hepatocellular carcinoma: toward zero hospital deaths. Ann Surg 229:322–330
Bruns H, Krätschmer K, Hinz U, Brechtel A, Keller M, Büchler M, Schemmer P (2010) Quality of life after curative liver resection: a single center analysis. World J Gastroenterol 16:2388–2395
Nicoud IB, Jones CM, Pierce JM, Earl TM, Matrisian LM, Chari RS, Gorden DL (2007) Warm hepatic ischemia-reperfusion promotes growth of colorectal carcinoma micrometastases in mouse liver via matrix metalloproteinase-9 induction. Cancer Res 67:2720–2728
van der Bilt JDW, Kranenburg O, Verheem A, van Hillegersberg R, BorelRinkes IHM (2006) Selective portal clamping to minimize hepatic ischaemia-reperfusion damage and avoid accelerated outgrowth of experimental colorectal liver metastases. Br J Surg 93:1015–1022
Nijkamp MW, van der Bilt JD, Snoeren N, Hoogwater FJ, van Houdt WJ, Molenaar IQ, Kranenburg O, van Hillegersberg R, Borel Rinkes IH (2010) Prolonged portal triad clamping during liver surgery for colorectal liver metastases is associated with decreased time to hepatic tumour recurrence. Eur J Surg Oncol 36(2):182–188
Hoffmann K, Franz C, Hinz U, Schirmacher P, Herfarth C, Eichbaum M, Büchler MW, Schemmer P (2010) Liver resection for multimodal treatment of breast cancer metastases: identification of prognostic factors. Ann Surg Oncol 17(6):1546–1554
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
1 Electronic Supplementary Material
Below is the link to the electronic supplementary material.
ESM 1 (VIDEO 157 MB)
Rights and permissions
Copyright information
© 2012 Springer-Verlag Italia
About this chapter
Cite this chapter
Bruns, H., Weitz, J., Kremer, M., Büchler, M.W., Schemmer, P. (2012). Stapler Hepatectomy. In: Di Carlo, I. (eds) Open, Laparoscopic and Robotic Hepatic Transection. Springer, Milano. https://doi.org/10.1007/978-88-470-2622-3_10
Download citation
DOI: https://doi.org/10.1007/978-88-470-2622-3_10
Published:
Publisher Name: Springer, Milano
Print ISBN: 978-88-470-2621-6
Online ISBN: 978-88-470-2622-3
eBook Packages: MedicineMedicine (R0)