Utility of the Gyrus open forceps in hepatic parenchymal transection

Matthew R. Porembka, M. B Majella Doyle, Nicholas Hamilton, Peter O. Simon, Steven M. Strasberg, David C. Linehan, William G. Hawkins

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Objective: This study aimed to evaluate if the Gyrus open forceps is a safe and efficient tool for hepatic parenchymal transection. Background: Blood loss during hepatic transection remains a significant risk factor for morbidity and mortality associated with liver surgery. Various electrosurgical devices have been engineered to reduce blood loss. The Gyrus open forceps is a bipolar cautery device which has recently been introduced into hepatic surgery. Methods: We conducted a single-institution, retrospective review of all liver resections performed from November 2005 through November 2007. Patients undergoing resection of at least two liver segments where the Gyrus was the primary method of transection were included. Patient charts were reviewed; clinicopathological data were collected. Results: Of the 215 open liver resections performed during the study period, 47 patients met the inclusion criteria. Mean patient age was 61 years; 34% were female. The majority required resection for malignant disease (94%); frequent indications included colorectal metastasis (66%), hepatocellular carcinoma (6%) and cholangiocarcinoma (4%). Right hemihepatectomy (49%), left hemihepatectomy (13%) and right trisectionectomy (13%) were the most frequently performed procedures. A total of 26 patients (55%) underwent a major ancillary procedure concurrently. There were no operative mortalities. Median operative time was 220 min (range 97-398 min). Inflow occlusion was required in nine patients (19%) for a median time of 12 min (range 3-30 min). Median total estimated blood loss was 400 ml (range 10-2000 ml) and 10 patients (21%) required perioperative transfusion. All patients had macroscopically negative margins. Median length of stay was 8 days. Two patients (4%) had clinically significant bile leak. The 30-day postoperative mortality was zero. Conclusions: Use of the Gyrus open forceps appears to be a safe and efficient manner of hepatic parenchymal transection which allows rapid transection with acceptable blood loss, a low rate of perioperative transfusion, and minimal postoperative bile leak.

Original languageEnglish (US)
Pages (from-to)258-263
Number of pages6
JournalHPB
Volume11
Issue number3
DOIs
StatePublished - 2009
Externally publishedYes

Fingerprint

Surgical Instruments
Liver
Bile
Mortality
Cautery
Equipment and Supplies
Cholangiocarcinoma
Operative Time
Hepatocellular Carcinoma
Length of Stay
Neoplasm Metastasis
Morbidity

Keywords

  • Gyrus device
  • Hepatic transection
  • Liver surgery

ASJC Scopus subject areas

  • Gastroenterology
  • Hepatology

Cite this

Porembka, M. R., Doyle, M. B. M., Hamilton, N., Simon, P. O., Strasberg, S. M., Linehan, D. C., & Hawkins, W. G. (2009). Utility of the Gyrus open forceps in hepatic parenchymal transection. HPB, 11(3), 258-263. https://doi.org/10.1111/j.1477-2574.2009.00048.x

Utility of the Gyrus open forceps in hepatic parenchymal transection. / Porembka, Matthew R.; Doyle, M. B Majella; Hamilton, Nicholas; Simon, Peter O.; Strasberg, Steven M.; Linehan, David C.; Hawkins, William G.

In: HPB, Vol. 11, No. 3, 2009, p. 258-263.

Research output: Contribution to journalArticle

Porembka, MR, Doyle, MBM, Hamilton, N, Simon, PO, Strasberg, SM, Linehan, DC & Hawkins, WG 2009, 'Utility of the Gyrus open forceps in hepatic parenchymal transection', HPB, vol. 11, no. 3, pp. 258-263. https://doi.org/10.1111/j.1477-2574.2009.00048.x
Porembka MR, Doyle MBM, Hamilton N, Simon PO, Strasberg SM, Linehan DC et al. Utility of the Gyrus open forceps in hepatic parenchymal transection. HPB. 2009;11(3):258-263. https://doi.org/10.1111/j.1477-2574.2009.00048.x
Porembka, Matthew R. ; Doyle, M. B Majella ; Hamilton, Nicholas ; Simon, Peter O. ; Strasberg, Steven M. ; Linehan, David C. ; Hawkins, William G. / Utility of the Gyrus open forceps in hepatic parenchymal transection. In: HPB. 2009 ; Vol. 11, No. 3. pp. 258-263.
@article{2595f4308e8d4abb9106680e42b9a708,
title = "Utility of the Gyrus open forceps in hepatic parenchymal transection",
abstract = "Objective: This study aimed to evaluate if the Gyrus open forceps is a safe and efficient tool for hepatic parenchymal transection. Background: Blood loss during hepatic transection remains a significant risk factor for morbidity and mortality associated with liver surgery. Various electrosurgical devices have been engineered to reduce blood loss. The Gyrus open forceps is a bipolar cautery device which has recently been introduced into hepatic surgery. Methods: We conducted a single-institution, retrospective review of all liver resections performed from November 2005 through November 2007. Patients undergoing resection of at least two liver segments where the Gyrus was the primary method of transection were included. Patient charts were reviewed; clinicopathological data were collected. Results: Of the 215 open liver resections performed during the study period, 47 patients met the inclusion criteria. Mean patient age was 61 years; 34{\%} were female. The majority required resection for malignant disease (94{\%}); frequent indications included colorectal metastasis (66{\%}), hepatocellular carcinoma (6{\%}) and cholangiocarcinoma (4{\%}). Right hemihepatectomy (49{\%}), left hemihepatectomy (13{\%}) and right trisectionectomy (13{\%}) were the most frequently performed procedures. A total of 26 patients (55{\%}) underwent a major ancillary procedure concurrently. There were no operative mortalities. Median operative time was 220 min (range 97-398 min). Inflow occlusion was required in nine patients (19{\%}) for a median time of 12 min (range 3-30 min). Median total estimated blood loss was 400 ml (range 10-2000 ml) and 10 patients (21{\%}) required perioperative transfusion. All patients had macroscopically negative margins. Median length of stay was 8 days. Two patients (4{\%}) had clinically significant bile leak. The 30-day postoperative mortality was zero. Conclusions: Use of the Gyrus open forceps appears to be a safe and efficient manner of hepatic parenchymal transection which allows rapid transection with acceptable blood loss, a low rate of perioperative transfusion, and minimal postoperative bile leak.",
keywords = "Gyrus device, Hepatic transection, Liver surgery",
author = "Porembka, {Matthew R.} and Doyle, {M. B Majella} and Nicholas Hamilton and Simon, {Peter O.} and Strasberg, {Steven M.} and Linehan, {David C.} and Hawkins, {William G.}",
year = "2009",
doi = "10.1111/j.1477-2574.2009.00048.x",
language = "English (US)",
volume = "11",
pages = "258--263",
journal = "HPB",
issn = "1365-182X",
publisher = "John Wiley and Sons Inc.",
number = "3",

}

TY - JOUR

T1 - Utility of the Gyrus open forceps in hepatic parenchymal transection

AU - Porembka, Matthew R.

AU - Doyle, M. B Majella

AU - Hamilton, Nicholas

AU - Simon, Peter O.

AU - Strasberg, Steven M.

AU - Linehan, David C.

AU - Hawkins, William G.

PY - 2009

Y1 - 2009

N2 - Objective: This study aimed to evaluate if the Gyrus open forceps is a safe and efficient tool for hepatic parenchymal transection. Background: Blood loss during hepatic transection remains a significant risk factor for morbidity and mortality associated with liver surgery. Various electrosurgical devices have been engineered to reduce blood loss. The Gyrus open forceps is a bipolar cautery device which has recently been introduced into hepatic surgery. Methods: We conducted a single-institution, retrospective review of all liver resections performed from November 2005 through November 2007. Patients undergoing resection of at least two liver segments where the Gyrus was the primary method of transection were included. Patient charts were reviewed; clinicopathological data were collected. Results: Of the 215 open liver resections performed during the study period, 47 patients met the inclusion criteria. Mean patient age was 61 years; 34% were female. The majority required resection for malignant disease (94%); frequent indications included colorectal metastasis (66%), hepatocellular carcinoma (6%) and cholangiocarcinoma (4%). Right hemihepatectomy (49%), left hemihepatectomy (13%) and right trisectionectomy (13%) were the most frequently performed procedures. A total of 26 patients (55%) underwent a major ancillary procedure concurrently. There were no operative mortalities. Median operative time was 220 min (range 97-398 min). Inflow occlusion was required in nine patients (19%) for a median time of 12 min (range 3-30 min). Median total estimated blood loss was 400 ml (range 10-2000 ml) and 10 patients (21%) required perioperative transfusion. All patients had macroscopically negative margins. Median length of stay was 8 days. Two patients (4%) had clinically significant bile leak. The 30-day postoperative mortality was zero. Conclusions: Use of the Gyrus open forceps appears to be a safe and efficient manner of hepatic parenchymal transection which allows rapid transection with acceptable blood loss, a low rate of perioperative transfusion, and minimal postoperative bile leak.

AB - Objective: This study aimed to evaluate if the Gyrus open forceps is a safe and efficient tool for hepatic parenchymal transection. Background: Blood loss during hepatic transection remains a significant risk factor for morbidity and mortality associated with liver surgery. Various electrosurgical devices have been engineered to reduce blood loss. The Gyrus open forceps is a bipolar cautery device which has recently been introduced into hepatic surgery. Methods: We conducted a single-institution, retrospective review of all liver resections performed from November 2005 through November 2007. Patients undergoing resection of at least two liver segments where the Gyrus was the primary method of transection were included. Patient charts were reviewed; clinicopathological data were collected. Results: Of the 215 open liver resections performed during the study period, 47 patients met the inclusion criteria. Mean patient age was 61 years; 34% were female. The majority required resection for malignant disease (94%); frequent indications included colorectal metastasis (66%), hepatocellular carcinoma (6%) and cholangiocarcinoma (4%). Right hemihepatectomy (49%), left hemihepatectomy (13%) and right trisectionectomy (13%) were the most frequently performed procedures. A total of 26 patients (55%) underwent a major ancillary procedure concurrently. There were no operative mortalities. Median operative time was 220 min (range 97-398 min). Inflow occlusion was required in nine patients (19%) for a median time of 12 min (range 3-30 min). Median total estimated blood loss was 400 ml (range 10-2000 ml) and 10 patients (21%) required perioperative transfusion. All patients had macroscopically negative margins. Median length of stay was 8 days. Two patients (4%) had clinically significant bile leak. The 30-day postoperative mortality was zero. Conclusions: Use of the Gyrus open forceps appears to be a safe and efficient manner of hepatic parenchymal transection which allows rapid transection with acceptable blood loss, a low rate of perioperative transfusion, and minimal postoperative bile leak.

KW - Gyrus device

KW - Hepatic transection

KW - Liver surgery

UR - http://www.scopus.com/inward/record.url?scp=66949180891&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=66949180891&partnerID=8YFLogxK

U2 - 10.1111/j.1477-2574.2009.00048.x

DO - 10.1111/j.1477-2574.2009.00048.x

M3 - Article

VL - 11

SP - 258

EP - 263

JO - HPB

JF - HPB

SN - 1365-182X

IS - 3

ER -