"Festination mode" in robotic liver parenchyma dissection скачать в хорошем качестве

"Festination mode" in robotic liver parenchyma dissection

Dear all, I read with interest @Jordi Navines et al article on robotic liver parenchyma dissection publish recently. Like him, I and others have long been interested in this long and laborious phase of hepatectomy. To date, the CUSA is the "weapon" of choice for open surgery and laparoscopic surgery alike, but its use remains debatable or complicated by the fact that it requires the use of an additional trocar, and that the user is not the console surgeon but rather the surgeon around the operating table..., with two major pitfalls: the additional cost and its non-optimal use (requiring another "real liver surgeon" to use it!). We have been using what we call "festination-mode" liver parenchyma dissection for a long time now, both by laparotomy and of course by laparoscopy. It combines a rapid but low-amplitude "close-open" movement of bipolar forceps, with cold or hot parenchymal breaks. We use it for our robotic liver surgeries with great satisfaction, either with two bipolar forceps, including a Maryland, or with one bipolar forceps and a robotic vessel sealer ( we prefer the Extend Vessel Sealer ). Here's a video with several cases ranging from simple hepatic wegde to right posterolateral sectionectomy, illustrating the "festination mode". Enjoy We are The Factory #ChirDeLux from Centre Hospitalier de Luxembourg