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| Magnetic-assisted laparoscopic liver transplantation in swine |
| Zhe Feng a , b , Shan-Pei Wang a , Hao-Hua Wang b , Qiang Lu c , Wei Qiao d , Kai-Ling Wang a , b , Hong-Fan Ding a , b , Yue Wang a , b , Rong-Feng Wang a , b , Ai-Hua Shi b , Bing-Yi Ren e , Yu-Nan Jiang e , Bin He e , Jia-Wei Yu e , Rong-Qian Wu b , Yi Lv a , b , ∗ |
a Department of Hepatobiliary Surgery, the First Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710061, China
b National Local Joint Engineering Research Center for Precision Surgery & Regenerative Medicine, Shaanxi Provincial Center for Regenerative Medicine and Surgical Engineering, Institute of Advanced Surgical Technology and Engineering, the First Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710061, China
c Department of Geriatric Surgery, the First Affiliated Hospital of Xi’an Jiaotong University, Xi’an 710061, China
d Department of Hepatobiliary Surgery, Shaanxi Provincial People’s Hospital, Xi’an 710000, China e Zonglian College, Xi’an Jiaotong University, Xi’an 710000, China
∗ Corresponding author at: Department of Hepatobiliary Surgery, the First Affiliated Hospital of Xi’an Jiaotong University, 277 West Yanta Road, Xi’an 710061, China.
E-mail address: luyi169@126.com (Y. Lv). |
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Abstract Background: Although laparoscopic technology has achieved rapid development in the surgical field, it has not been applied to liver transplantation, primarily because of difficulties associated with laparoscopic vascular anastomosis. In this study, we introduced a new magnetic-assisted vascular anastomosis technique and explored its application in laparoscopic liver transplantation in pigs.
Methods: Two sets of magnetic vascular anastomosis rings (MVARs) with different diameters were developed. One set was used for anastomosis of the suprahepatic vena cava (SHVC) and the other set was used for anastomosis of the infrahepatic vena cava (IHVC) and portal vein (PV). Six laparoscopic orthotopic liver transplantations were performed in pigs. Donor liver was obtained via open surgery. Hepatectomy was performed in the recipients through laparoscopic surgery. Anastomosis of the SHVC was performed using hand-assisted magnetic anastomosis, and the anastomosis of the IHVC and PV was performed by magnetic anastomosis with or without hand assistance.
Results: Liver transplants were successfully performed in five of the six cases. Postoperative ultrasonographic examination showed that the portal inflow was smooth. However, PV bending and blood flow obstruction occurred in one case because the MVARs were attached to each other. The durations of load- ing of MVAR in the laparoscope group and manual assistance group for IHVC and PV were 13 ±5 vs. 5 ±1 min ( P < 0.01) and 10 ±2 vs. 4 ±1 min ( P < 0.05), respectively. The durations of MVAR anastomosis in the laparoscope group and manual assistance group for IHVC and PV were 5 ±1 vs. 1 ±1 min ( P < 0.01), and 5 ±1 vs. 1 ±1 min ( P < 0.01), respectively. The anhepatic phase was 43 ±4 min in the laparoscope group and 23 ±2 min in the manual assistance group ( P < 0.01).
Conclusions: Our study showed that magnetic-assisted laparoscopic liver transplantation can be successfully carried out in pigs.
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2022, Vol. 21 
