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Box 2.4 Instrumentation for Hepatic Surgery

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 Routine soft tissue instrument set

 Balfour retractor

 Monopolar cautery

 Sterile suction tubing

 Multiple suction canister

 Lap sponges

 Stapling equipment (Figure 2.3 and Table 2.1)

 Vessel sealing device (LigaSure) (Figure 2.4)

 Weck Hemoclips®, Ethicon Ligaclips®, or Covidien Surgiclips® (Figure 2.5)

 Vetspon absorbable hemostatic gelatin sponge (Figure 2.5)

 Oxidized regenerated cellulose (Figure 2.5)


Figure 2.3 Stapling device and cartridge options.

Table 2.1 Stapling cartridge information chart.

Instrument cartridge Staplesa
Width × height (mm) Closed height (mm) Configuration
TA 30. 55. 90 blue 4.0 × 3.5 1.5 Double staggered row of staples
TA 30. 55. 90green 4.0 × 4.8 2.0 Double staggered row of staples
TA 30–V3 whiteb 3.0 × 2.5 1.0 3 staggered rows
GIA 50 4.0 × 4.0 1.75 4 staggered rows of staples with a cut
GIA 60 3.0 × 2.5 1.0
GIA 60 or 80 3.0 × 3.85 1.5 between 2
GIA 90 4.0 × 4.0 1.75

a Absorbable staples: PDS and glycolic acids; stainless steel 316 l.

b Vascular.


Figure 2.4 The bipolar vessel sealing device (LigaSure, Medtronics, Dublin Ireland), comes in many size and shape options. The device aides in decreasing intraoperative and postoperative hemorrhage.


Figure 2.5 An assortment of Hemoclip® and Ligaclip® sizes, Surgicel®, Vetspon® (Gel‐foam®), and Surgiclip® applicator (bottom). Both Gel‐foam and Surgicel are applied to a site to aid in clot formation and can be left in place indefinitely until eventually absorbed, or they can be removed during surgery once hemostasis is achieved.

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