关键词: 腹腔镜, 肝切除术, 肝实质离断, 器械

Abstract:

Approach for instruments selection and parenchyma dissection during laparoscopic hepatectomy        LIU Lian-xin, LIANG Ying-jian. Department of Hepatic Surgery，the First Affiliated Hospital of Harbin Medical University, Harbin 150001, China
Corresponding author: LIU Lian-xin, E-mail: liulianxin@ medmail.com.cn
Abstract    The liver parenchyma dissection technology is the key to the success of the surgery. Numerous instruments are now used for liver transaction according to personal preference. However, harmonic ACE and CUSA are favor selection for the majority surgeons. Well performed mobilization and total inflow occlusion are the prerequisites before parenchyma transaction which is indeed a team work. Blood vessels in the surface of the liver parenchyma is less, can be dissected directly using harmonic ACE. On the contrary, the vessels constitution in central parenchyma are intricate. Simple dissection directly may lead to catastrophic bleeding. Identifying each important vessel using crash maneuver by harmonic ACE is suggested. Bipolar coagulator works well for weak bleeding. However, complete suturing is necessary for the bleeding of major vessels.

Key words: laparoscopy, hepatectomy, liver parenchyma dissection, instruments