Vor Luvira, Chalisa Suwanprinya, Yodkhwan Laochuvong, Theerawee Tipwaratorn

Department of Surgery, Khon Kaen University Faculty of Medicine, Khon Kaen, Thailand


The use of a sealing device during video-assisted liver transection has gained a lot of popularity due to its advantages in operative and patient outcomes. However, it has some technical problems including tissue debris sticking to the instrument, excessive smoke production, and loss of pneumoperitoneum from suction. Herein, we describe a novel ‘Waterfall’ technique that uses continuous irrigation of saline directly on the transection plane. This technique washes away tissue particles and smoke, clears the operative view, and improves the effectiveness of tissue sealing.

Keywords: Hepatectomy, laparoscopic, liver transection, sealing device, video-assisted

Cite this article as: Luvira V, Suwanprinya C, Laochuvong Y, Tipwaratorn T. Continuous saline irrigation during videoassisted liver transection: The ‘Waterfall’ technique. Turk J Surg 2023; 39 (3): 281-282.


Peer Review

Externally peer-reviewed.

Author Contributions

Concept - VL, CS, YL, TT; Design - VL, CS, YL, TT; Supervision - VL, CS, YL, TT; Materials - VL, CS, YL, TT; Data Collection and/or Processing - VL, CS; Literature Search - VL, CS; Writing Manuscript - VL, CS, TT; Critical Reviews - YL, TT.

Conflict of Interest

The authors have no conflicts of interest to declare.

Financial Disclosure

The authors declared that this study has received no financial support.