Jefferson University Hospitals

Bloodless Liver Resection

If you have localized liver cancer or another liver disease that requires a liver resection, a "bloodless" liver resection offers a much safer alternative to traditional surgery. The liver receives blood from two major sources — a large vein coming from the intestines and a large artery — which makes it challenging for any surgeon to make incisions using traditional methods. When the traditional method is performed, as many as five to 10 units of blood or more are needed. The "bloodless" resection technique has changed all of that.

What Does Bloodless Liver Resection Involve?

Instead of using a scalpel, a device called a cavitational ultrasonic surgical aspirator, or CUSA, which uses ultrasonic waves to aspirate (suction out) liver cells, is used, leaving behind only a skeleton of blood vessels. A second tool called an Aquamantys, which uses electrical energy to seal vessels which a stream of saline prevents adherence of the device to the liver tissue. 

Combining these tools reduces surgical time by nearly half (only two to four hours with the "bloodless" method, contrasted with the four to six hours of a traditional resection). The technique also confines any tissue damage to a much smaller area than if a scalpel had been used.

With "bloodless" liver resection, patients are generally up and walking 24 hours after surgery, remain in the Hospital only five to seven days (compared with 10 to 14), are back to regular activities in two weeks (as opposed to four) and completely recovered in one month. Up to 75 percent of a patient's liver can be removed safely with this technique. The resected liver can regenerate to its original size in two to three weeks.

Outstanding Success in Liver Disease Treatment at Jefferson

This technique which vastly reduces blood loss has been the standard process for liver resections done within Jefferson’s Transplantation Division. Jefferson's Liver Transplant Program has a long tradition of outstanding success in the treatment of patients with all forms of acute and chronic liver disease. Initiated in 1984, Jefferson has been the longest continuously active liver transplantation program in the Philadelphia area where our surgeons have performed more than 500 liver transplants.