caa a22 4500 475753194 CHVBK 20180406123530.0 cr unu---uuuuu 170329e20001001xx s 000 0 eng 10.1007/s005950070055 doi (NATIONALLICENCE)springer-10.1007/s005950070055 Hepatic resection using the harmonic scalpel [Elektronische Daten] [Hiroyuki Sugo, Youshi Mikami, Fumio Matsumoto, Hidenori Tsumura, Yozo Watanabe, Kuniaki Kojima, Shunji Futagawa] We describe herein our technique of performing extensive resection of the liver by blunt dissection in combination with excision using a harmonic scalpel. A ball coagulator was inserted at 3-cm intervals along the proposed cutting line in the liver, and the liver parenchyma between these holes was then cut using coagulation shears. Regardless of the condition of the liver, good coagulation and cutting were achieved using the harmonic scalpel without vascular occlusion when dividing the shallow layer of the liver, and no complications in association with the harmonic scalpel, such as postoperative bleeding, bile leakage, or abscess formation at the cut margins, occurred. In the deep layer below the main trunk of the hepatic vein, blunt dissection was used, since it was difficult to achieve sufficient control of bleeding from large vessels using the harmonic scalpel alone. Therefore, when used in combination with other techniques, the harmonic scalpel appears to be an effective device for liver surgery that minimizes bleeding and decreases the vascular clamping time. Springer-Verlag, 2000 Liver resection nationallicence Harmonic scalpel nationallicence Hepatocellular carcinoma nationallicence Sugo Hiroyuki Department of Surgery, Koshigaya Municipal Hospital, 10-47-1 Higashikoshigaya, 343-0023, Koshigaya, Saitama, Japan aut Mikami Youshi Department of Surgery, Koshigaya Municipal Hospital, 10-47-1 Higashikoshigaya, 343-0023, Koshigaya, Saitama, Japan aut Matsumoto Fumio Department of Surgery, Koshigaya Municipal Hospital, 10-47-1 Higashikoshigaya, 343-0023, Koshigaya, Saitama, Japan aut Tsumura Hidenori Department of Surgery, Koshigaya Municipal Hospital, 10-47-1 Higashikoshigaya, 343-0023, Koshigaya, Saitama, Japan aut Watanabe Yozo Department of Surgery, Koshigaya Municipal Hospital, 10-47-1 Higashikoshigaya, 343-0023, Koshigaya, Saitama, Japan aut Kojima Kuniaki Second Department of Surgery, Juntendo University, School of Medicine, 2-1-1 Hongo, Bunkyo-ku, 113-8421, Tokyo, Japan aut Futagawa Shunji Second Department of Surgery, Juntendo University, School of Medicine, 2-1-1 Hongo, Bunkyo-ku, 113-8421, Tokyo, Japan aut Surgery Today Springer-Verlag 30/10(2000-10-01), 959-962 0941-1291 30:10<959 2000 30 595 https://doi.org/10.1007/s005950070055 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s005950070055 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Sugo Hiroyuki Department of Surgery, Koshigaya Municipal Hospital, 10-47-1 Higashikoshigaya, 343-0023, Koshigaya, Saitama, Japan aut NATIONALLICENCE 700 1- Mikami Youshi Department of Surgery, Koshigaya Municipal Hospital, 10-47-1 Higashikoshigaya, 343-0023, Koshigaya, Saitama, Japan aut NATIONALLICENCE 700 1- Matsumoto Fumio Department of Surgery, Koshigaya Municipal Hospital, 10-47-1 Higashikoshigaya, 343-0023, Koshigaya, Saitama, Japan aut NATIONALLICENCE 700 1- Tsumura Hidenori Department of Surgery, Koshigaya Municipal Hospital, 10-47-1 Higashikoshigaya, 343-0023, Koshigaya, Saitama, Japan aut NATIONALLICENCE 700 1- Watanabe Yozo Department of Surgery, Koshigaya Municipal Hospital, 10-47-1 Higashikoshigaya, 343-0023, Koshigaya, Saitama, Japan aut NATIONALLICENCE 700 1- Kojima Kuniaki Second Department of Surgery, Juntendo University, School of Medicine, 2-1-1 Hongo, Bunkyo-ku, 113-8421, Tokyo, Japan aut NATIONALLICENCE 700 1- Futagawa Shunji Second Department of Surgery, Juntendo University, School of Medicine, 2-1-1 Hongo, Bunkyo-ku, 113-8421, Tokyo, Japan aut NATIONALLICENCE 773 0- Surgery Today Springer-Verlag 30/10(2000-10-01), 959-962 0941-1291 30:10<959 2000 30 595 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer