Comparison of 5 Surgical Techniques for Partial Liver Lobectomy in the Dog for Intraoperative Blood Loss and Surgical Time

• Published in: Veterinary surgery Vol. 39; no. 7; pp. 856 - 862
• Main Authors: Risselada, Marije, Ellison, Gary W, Bacon, Nicholas J, Polyak, Maximilian M.R, van Gilder, Jim, Kirkby, Kristin, Kim, Stanley E
• Format: Journal Article
• Language: English
• Published: Malden, USA Malden, USA : Blackwell Publishing Inc 01-10-2010; Blackwell Publishing Inc; Blackwell Publishing Ltd
• Subjects: Animals; automation; biomarkers; blood; Blood Coagulation; Blood Loss, Surgical - prevention & control; Blood Loss, Surgical - veterinary; Comparative studies; dog diseases; Dogs; Dogs - surgery; excision; harmonic scalpel; hemorrhage; hemostasis; Hemostasis, Surgical - methods; Hemostasis, Surgical - veterinary; Hepatectomy - methods; Hepatectomy - veterinary; Liver; liver diseases; Male; methodology; partial liver lobectomy; postoperative complications; scalpels; skeletonization; Surgical outcomes; Surgical techniques; sutures; Time Factors; Veterinary medicine
• ISSN: 0161-3499; 1532-950X
• DOI: 10.1111/j.1532-950X.2010.00719.x

To compare surgical time and intraoperative blood loss for 5 partial liver lobectomy techniques in the dog. Experimental in vivo study. Dogs (n=10). Five surgical techniques (SurgiTie[trade mark sign]; LigaSure[trade mark sign]; Ultracision® Harmonic Scalpel [UAS]; Suction+Clip; Suction+thoracoabdominal stapler [TA]) for partial liver lobectomy in dogs were evaluated and compared for total surgical time and intraoperative blood loss. Body weight, activated clotting time (ACT), heart rate, and intraoperative blood pressure (BP) were recorded. Blood loss was determined by adding the weight of the blood soaked sponges during surgery (1 g=1 mL) to the amount of suctioned blood (mL). Surgical time (in seconds) was determined from the start of the lobectomy until cessation of bleeding from the stump. Mean surgical time and mean blood loss for each technique were compared using a Tukey's multiple comparison test. No significant differences were found between dogs for weight, ACT, heart rate, and intraoperative BP. No complications were seen with the SurgiTie[trade mark sign] technique in 9 of 10 cases. There was no significant difference in surgical time between techniques however there was a significant difference for blood loss; the Suction+Clip method had significantly more blood loss than the other techniques. Skeletonization of the lobar vessels before individually clipping them (Suction+Clip) resulted in a higher blood loss than using Suction+TA, UAS, SurgiTie[trade mark sign] or the LigaSure[trade mark sign] device. The SurgiTie[trade mark sign] appears to be an acceptable method for partial liver lobectomy. Although skeletonization and individually clipping the vessels had the highest blood loss, it still was <7.5% of total blood volume. All 5 techniques should be safe for clinical use in small to medium sized dogs up to 26 kg.