Suturing Method Using LapraTy® Clips Is Effective for Intraoperative Bile Leaks in Laparoscopic Hepatectomy.
Masahiro Shiihara, Mitsugi Shimoda, Ryoichi Miyamoto, Shuji Suzuki
Abstract
Open AccessTechnique: Troubleshooting unexpected complications during laparoscopic surgery demands a wealth of experience and skills. Importantly, a rapid and accurate suture technique is essential when addressing intraoperative issues such as bile leakage or bleeding. The LapraTy® suture clip, an absorbable clip that eliminates the need for ligation, has been recognized for its effectiveness. Here, we present a versatile suturing technique with LapraTy® suture clip for intraoperative accidental bile leakage (ABL). Our technique consists of 2 steps: suturing the hole of ABL using a LapraTy® suture clip and covering with the omentum. Results: The suturing technique using LapraTy® suture clip could offer rapid suture without applying excessive tension. Therefore, it is not only suitable for fragile tissues such as bile ducts but also could prevent Glissonial stenosis. Omental coverage may partly help to prevent postoperative bile leakage. Conclusion: This report highlights a closure technique utilizing LapraTy® suture clips with omental covering for ABL following Laparoscopic hepatectomy. Our findings revealed that the LapraTy® suture clip allows for suturing or anastomosis, even in emergent or difficult situations. Particularly, its advantage lies in the absence of ligation requirements, allowing for adjustable tightening without compromising tension in cases involving thickened or fragile tissues.