Treatment of Ongoing Hemorrhage by Chad G. Ball & Elijah Dixon

Author:Chad G. Ball & Elijah Dixon
Language: eng
Format: epub
Publisher: Springer International Publishing, Cham

Surgical Devices

Multiple surgical devices can be useful during liver transplantation to decrease bleeding during and after liver transplantation. Standard Bovie electrocautery is a mainstay of liver transplantation, and used for dissection as described above. The argon beam is also used frequently. The argon beam uses a jet of argon gas to distribute radiofrequency current to a bleeding surface. It is best used for superficial surface bleeding. In liver transplantation, it is useful for all of the raw surfaces, especially portal hypertensive bleeding from small collaterals. A bipolar electrothermal vessel sealer is very useful for dissection and can be used in vessels up to 7 mm in width. It is useful for ligation of small- to medium-sized collaterals as well as the short hepatic branches off of the vena cava. The radiofrequency dissecting sealer is rarely used in liver transplantation, unless the graft is a split liver (either living or deceased donor) and there is a cut surface that needs coagulation. Large liver lacerations may also benefit from this device.

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