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. 2011 Mar;149(3):438-44.
doi: 10.1016/j.surg.2009.11.015. Epub 2010 Jan 18.

A novel method using the VIO soft-coagulation system for liver resection

Fumitoshi Hirokawa  1 , Michihiro Hayashi, Yoshiharu Miyamoto, Mitsuhiko Iwamoto, Ichiro Tsunematsu, Mitsuhiro Asakuma, Tetsunosuke Shimizu, Koji Komeda, Yoshihiro Inoue, Nobuhiko Tanigawa
Affiliations

A novel method using the VIO soft-coagulation system for liver resection

Fumitoshi Hirokawa et al. Surgery. 2011 Mar.

Abstract

Background: The VIO soft-coagulation system (SCS) is a new device for tissue coagulation. The current study evaluated the efficacy of the SCS when used for liver resection.

Methods: The 252 patients were divided into 2 groups; in 155 patients (conventional group), liver transection was performed using an ultrasonic dissector and saline-coupled bipolar electrocautery for hemostasis. In 97 patients (SCS group), the SCS was used instead of bipolar electrocautery.

Results: The median blood loss and surgical time were less in the SCS group than in the conventional group (350 vs 640 mL, P = .0028; 280 vs 398 min, P < .0001). No significant differences were found in postoperative complications between the SCS group (32.0%) and the conventional group (40.6%). The risk factors for bleeding were nonuse of the SCS (P = .0039), macroscopic vascular invasion of the hepatic tumors (P = .0088), and collagen type IV value in the sera >200 (P = .0250) on multivariate analysis. In a subgroup analysis, in the collagen type IV value >200 subgroup, the tumor diameter >5 cm subgroup, and the inflow nonocclusion subgroup, use of the SCS decreased surgical bleeding (P = .0120, P = .0126, and P = .0032, respectively) and surgical time (P = .0001, P < .0001, and P = .0036, respectively) compared with the conventional group. Furthermore, even in the major hepatectomy group, the SCS use decreased surgical time (P < .0001).

Conclusion: The SCS is an effective and safe device for decreasing surgical time and surgical bleeding without increasing the rate of bile leakage and causing other complications.

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