 With advances in surgical procedures and equipment, modern technologies have been introduced, which shortened operation time and improved surgical outcomes. Exquisite equipment for liver parenchyma transection, such as Cavitron ultrasonic surgical aspirator, ultrasonic dissector USD, LigaSure LS and Tissue Link can also be used to reduce hemorrhage in liver resection. The ultrasonic scalpel Ethicon is a new USD that cuts and coagulates tissue with ultrasound, using higher frequencies than an ultrasonic aspirator. This device can also serve as a grasper and basically involves a blade oscillating at 55 kHz, producing heat and coagulation of vessels. Recently, its use and potential advantages in open liver resection have been demonstrated. The main technical advance relates to decreased intra-operative bleeding. Results of using USD Harmonic Scalpel during recipient hepatectomy showed that this method is safe compared with conventional knot tying ligation regarding intra- and postoperative bleeding rate. The electrothermal bipolar vessel sealing device LS is another alternative, which applies electrothermal bipolar coagulation and dissection in one step. The LS dissection device is sealing the tissue first before it is divided both performed with the same device. This may prevent severe bleeding. Furthermore, the sealing device is able to cope with the small liver veins which can be sealed and divided safely without the need for sutures or clips. Especially the latter could interfere with sufficient tangential clamping of the inferior caval vein IVC for side to side cavo-cavostomy during piggy back LT. It was reported that use of LS device for recipient hepatectomy in LT. It was concluded that, LS vessel sealing is an efficient method and vessel sealing of caval, portal, and other structures can be safely performed in the setting of end-stage liver disease. 