We have been using Debakey forceps for liver transections in all our liver resections for the past 8 years.
These four groups were compared in terms of age, gender, comorbid conditions, transection time, total operative time, postoperative length of hospital stay, blood transfusion rates, morbidity, and mortality to evaluate the effect of type of liver parenchyma with use of Debakey forceps crushing technique for liver parenchyma transection.
The design along with mechanism of functioning of Debakey forceps and Kelly clamps was studied and compared using photographs taken during operation.
Then the parenchyma was crushed using fine tip (1 mm), 8 cm long straight or 9 cm long angled Debakey forceps depending on the depth of transection followed by coagulation of the small vessels of <2mm size using monopolar electrocautery and ligation of the biliary and larger vascular pedicles using 2-0/3-0 silk sutures.
Debakey forceps has some differences over Kelly clamp on the basis of its design.
Figures 1-8 (photographs) depict wrist joint postures during liver parenchyma transection while using Kelly clamp and Debakey forceps. It is clear in Figures 2, 6, 7, and 8 that the wrist joint always remains in neutral posture during liver parenchyma transection with Debakey forceps at various depths and angles.
This study shows that use of Debakey forceps crushing technique is safe and effective for liver parenchymal transection; transection time and total operative time improve with surgeon experience and it has ergonomic advantages over Kelly clamp technique.