Microsurgical Techniques for Researching Liver Diseases: A Review

Review Article

Microsurgical Techniques for Researching Liver Diseases: A Review

MA Aller¹, M Méndez², M Méndez‐López², S Argudo³, N Arias², L Lorente¹, JL Arias² and J Arias¹

Affiliations: ¹Surgery I Department, School of Medicine, Complutense University of Madrid and ²Neurosciences Unit, Psychobiology Department, School of Psychology, University of Oviedo and ³General Surgery Unit, Sudeste Hospital, Arganda del Rey

ABSTRACT

The development of microsurgical techniques has been dependent on experimental animals, and has been driven by the demands of human surgery for more sophisticated techniques and by the need for novel laboratory models in biomedical research. In this context, microsurgery could be a very valuable technique to improve experimental models of hepatic insufficiency. Microdissection and microsutures are the two main microsurgical techniques that can be considered for classifying the experimental models developed. Simple and triple partial portal vein ligation, cholestasis, and hepatectomies are all models based on microdissection. On the other hand, in portacaval shunt and orthotopic and heterotopic liver transplantation, the microsuture techniques stand out. By reducing surgical complications, these microsurgical techniques allow for improving the resulting experimental models. Thus, liver atrophy related to portacaval shunt, prehepatic portal hypertension secondary to partial portal vein ligation, cholestasis by resection of the extrahepatic biliary tract, hepatic regeneration after partial hepatectomies, acute liver failure associated with subtotal or total hepatectomy, and finally complications derived from preservation or rejection in orthotopic and heterotopic liver transplantation can be studied in more standardized experimental models. If good experimental models for liver research are successfully developed, the results obtained from their study might be particularly useful in patients with acute and chronic liver diseases. Therefore, experimental liver microsurgery could be an invaluable way to translate laboratory data on liver research into new clinical therapeutic strategies.

Keywords: Microsurgery, operating microscope, liver, rat, portal hypertension, cholestasis, portacaval shunt, hepatectomy, transplantation

Correspondence: Maria‐Angeles Aller, Cátedra de Cirugía, Facultad de Medicina, Universidad Complutense de Madrid, Pza. de Ramón y Cajal s.n., 28040 Madrid, Spain. Tel: (34)‐91‐394‐1388; Fax: (34)‐91‐3947115; e‐mail: maaller@med.ucm.es