Water jet dissection
Five years ago, surgeons at the Lukas Hospital in Neuss, Germany, used water jet dissection for visceral surgery for the first time. Dr Bernhard Lammers, head of the hospital’s General and Visceral Surgery Department, describes subsequent experiences with this procedure and possible future developments
Water jet dissection has fulfilled the expectations of the experts - and more.
Bernhard Lammers
Advantages
‘One advantage lies in surgery for liver metastases. With many metastases in the left and right lobes of the liver we can now carry out larger resections, thanks to this tissue-preserving type of dissection, and we therefore we can remove more liver metastases. The incredible precision in the removal of malignant cells and preservation of healthy tissue achieved with the water jet has astonished us. The fact that out of a total of 100 operations the blood supply to the liver had to be stopped during only one of those operations is further proof of how precise the method is. In all other cases, the liver’s arterial supply was maintained throughout the whole surgical procedure. We also have been able to significantly lower the amount of blood loss occurring during surgery. On average, patients lost around 350ml, and around 80% of our tumour patients did not need any blood transfusions or plasma. This presents an enormous relief for the patients’ organs.
‘We have also found that, in general, patients recover from this type of surgery much faster. In addition, there is definitely a lower rate of infectious complications. Problems with liver function or liver failure hardly ever occur. A further positive effect has been seen in surgery on rectal carcinoma. As the nerves are protected during this type of surgery, 97% of patients who underwent resection of the rectum with total excision did not require a catheter. Before the introduction of water jet dissection around 50% of patients left hospital with a catheter! We can say with confidence that due to water jet dissection the healing process is faster and patients are mobilised quicker. Apart from the obvious health benefits to the patients, there is also a cost-saving element as patients’ hospital stays are reduced.’
The future Liver tissue and the waterjet applicator
‘Over the last few years this method, and its uses, have developed and evolved continuously. Apart from visceral surgery, the method is now also increasingly used in urology, for instance in prostate surgery. We continuously exchange information and experiences with colleagues in different medical fields, so there are other developments, as well. We are always curious to see what other positive surprises this procedure will have in store for us.’
Interview: Denise Hennig, European Hospital
ERBE’s core competence is electrosurgery. For about five years ERBE Elektromedizin GmbH has extended its product portfolio to include waterjet technology, which enables surgical interventions with optimised preservation of nerves and vessels.
Dissected liver tissue with network of exposed vessels. These can be treated individually according to size
Full details: www.erbe-med.de
This article was published on 08/30/2006