Abstract\nBackground: Preservation of the hepatic vessels while dividing the parenchyma is\nkey to achieving safe liver resection in a timely manner. In this study, we assessed the\nfeasibility of a newly developed, piezo actuator-driven pulsed water jet (ADPJ) for liver\nresection in a surviving swine model.\nMethods: Ten domestic pigs underwent liver resection. Parenchymal transection and\nvessel skeletonization were performed using the ADPJ (group A, n = 5) or an ultrasonic\naspirator (group U, n = 5). The water jet was applied at a frequency of 400 Hz and a\ndriving voltage of 80 V. Physiological saline was supplied at a flow rate of 7 ml/min.\nAfter 7 days, the animals were killed and their short-term complications were examined\nand compared between the two groups.\nResults: No significant complications, such as massive bleeding, occurred in either\ngroup during the surgical procedures. The transection time per transection area\nwas significantly shorter in group A than in group U (1.5 �± 0.3 vs. 2.3 �± 0.5 min/cm2,\nrespectively, P = 0.03). Blood loss per transection area was not significantly different\nbetween groups A and U (9.3 �± 4.2 vs. 11.7 �± 2.3 ml/cm2, P = 0.6). All pigs in group\nA survived for 7 days. No postoperative bleeding or bile leakage was observed in any\nanimal at necropsy.\nConclusion: The present results suggested that the ADPJ reduces transection time\nwithout increasing blood loss. ADPJ is a safe and feasible device for liver parenchymal\ntransection.
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