ArticleSurgical endoscopy2025
Devices for minimally invasive liver parenchyma transection: the SICE (Italian Society of Endoscopic Surgery) Italian and International survey.
Article in Surgical endoscopy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07750275 (Safety and Economics of Parenchymal Transection in Minimally Invasive Liver Surgery), which is not on this map. Cited by 5 papers, 3 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Safety and Economics of Parenchymal Transection in Minimally Invasive Liver Surgery (LIVER-MIND 2): a Multicentre Retrospective Registry of the Italian Society of Endoscopic Surgery (SICE)
Who cites it
5 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Robotic hepatectomy for benign liver disease: single-centre consecutive series and meta-analysis comparing minimally invasive and open approaches.Journal of robotic surgery · 2026Pooled it
- Imaging-based 3D-printed anatomical models for preoperative planning in hepatopancreatobiliary surgery: a single-center pilot study, cost analysis, and systematic review.La Radiologia medica · 2026Pooled it
- Updated overview of robotic hepatic parenchymal transection techniques: technical developments, international perspectives, and future directions.Journal of robotic surgery · 2026Pooled it
- Improving cost-efficiency in port-site fascial closure: a novel Veress-needle technique and a comprehensive literature review.Updates in surgery · 2026Article
- An Australian perspective of using video for the assessment of laparoscopic surgery and support for artificial intelligence in performance evaluation.Langenbeck's archives of surgery · 2026Article
Corrections and comments
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Authors and funding
10 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundsMinimally Invasive Liver Surgery (MILS), encompassing laparoscopic (L-MILS) and robotic (R-MILS) approaches, has revolutionized liver surgery, offering reduced morbidity, shorter hospital stays, and improved outcomes while maintaining oncological efficacy. Despite the widespread use of L-MILS, parenchyma liver transection techniques and devices remain debated. This study investigates the adoption of transection devices (TDs) in MILS among 86 hospitals, focusing on surgical practices, device utilization, and outcomes.
methodsThe Italian Society of Endoscopic Surgery (SICE) endorsed a cross-sectional internet-based survey targeting general and Hepato-Pancreato-Biliary surgeons.
resultsResponses from 86 centers revealed that 77% of institutions is available a robotic platform, with an adoption rate of 87.50% in high-volume centers. L-MILS remains the predominant technique for liver resections, also in case of major hepatectomies, although R-MILS is increasingly utilized. For minor L-MILS, more than 50% of respondents use ultrasonic shears and electrosurgical pencil and advanced bipolar devices, while about 40% of surgeons adopt Cavitronic Ultrasonic Surgical Aspirator (CUSA) in major resections. R-MILS procedures predominantly used Maryland bipolar forceps and vessel sealers, with hybrid techniques (30%) integrating laparoscopic devices (e.g., CUSA) to address robotic device limitations.
conclusionThe minimally invasive approach to liver parenchymal transection is a key component of this surgical procedure. For major hepatectomies, the CUSA device remains the most effective tool, whereas ultrasonic shears, electrosurgical pencil, and advanced bipolar devices are more suited for minor resections. Despite limited access to specialized instruments, R-MILS achieves favorable outcomes in liver transection by employing the crash-clamp technique or hybrid strategies.
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