A simple tip for the use of staplers during liver surgery

摘要

The use of vascular staplers in liver resection is well established. An umbilical tape or sling is usually recommended to loop the portal or hepatic venous structures prior to stapling. However, these need to be removed before firing, or may be included in the fired stapler, and could cause the stapler to misfire. This results in lack of traction on the structure to be stapled, and a greater risk of the stapler being fired too close to the portal bifurcation or the inferior vena cava, respectively. This is particularly relevant in cases where hepatic veins are short and thick or exposure is poor (when cirrhotic or enlarged liver is present).