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

Authors

  • Marije Risselada DVM, PhD, Diplomate ECVS,

    1. Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL
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  • Gary W. Ellison DVM, MS, Diplomate ACVS,

    1. Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL
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  • Nicholas J. Bacon BA, VetMB, MA, Diplomate ACVS, ECVS,

    1. Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL
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  • Maximilian M.R. Polyak M Phil,

    1. Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL
    2. Department of Surgery, Transplant Center, College of Medicine, Shands, University of Florida, Gainesville, FL
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  • Jim Van Gilder BS,

    1. Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL
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  • Kristin Kirkby MS, DVM, Diplomate ACVS,

    1. Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL
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  • Stanley E. Kim BVSc, MS

    1. Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL
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  • Presented in part at the 2008 ACVS Symposium, October 22–25, 2008, San Diego, CA.

Corresponding Author
Marije Risselada DVM, PhD, Diplomate ECVS, Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, PO Box 100126, Gainesville FL 32610-0126.
E-mail: risseladam@ufl.edu

Abstract

Objective: To compare surgical time and intraoperative blood loss for 5 partial liver lobectomy techniques in the dog.

Study Design: Experimental in vivo study.

Animals: Dogs (n=10).

Methods: Five surgical techniques (SurgiTie; LigaSure; 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.

Results: No significant differences were found between dogs for weight, ACT, heart rate, and intraoperative BP. No complications were seen with the SurgiTie 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.

Conclusions: Skeletonization of the lobar vessels before individually clipping them (Suction+Clip) resulted in a higher blood loss than using Suction+TA, UAS, SurgiTie or the LigaSure device. The SurgiTie appears to be an acceptable method for partial liver lobectomy.

Clinical Relevance: 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.

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