Laparoscopic hepatic transection using stapler and cusa

Laparoscopy is associated with reduced blood loss and morbidity. Efficient and safe laparoscopic liver transection is dependent on the ability to simultaneously address two tasks: parenchymal division and hemostasis. Over the past years, technological advances have led to the development of specific instruments for liver transection, such as the ultrasonic dissector (CUSA) and stapler device, also for laparoscopic surgery. The former allows to fracture hepatocytes along the proposed line of division, leaving intact arteries, veins, and bile ducts crossing the line of division, and the uncovered bridging structures are then sealed and divided. Stapler use is reported in both transection of large vessels and parenchymal transection, especially in laparoscopy.