GATT-Patch Versus SURGICEL® Original in Minimally Invasive Liver and Gallbladder Surgery

Inclusion Criteria:

• Subject is scheduled to undergo elective minimally invasive (robotic orlaparoscopic) surgery on the liver, including cholecystectomy

• Subject is willing and able to give written informed consent for the clinicalinvestigation participation

• Subjects is 22 years of age or older at the time of enrollment; and

• Subject has been informed of the nature of the clinical investigation.

A subject must meet all of the following intra-operative inclusion criteria to be enrolled into the clinical investigation:

• Subject undergoes a fully minimally invasive surgical approach without the use of ahand port at the time of randomization and application of the patch;

• Subject in whom the Investigator is able to identify a target bleeding site at theliver resection plane for which any applicable conventional means for hemostasis (e.g. suture, ligature or cautery) are ineffective or impractical, and the choice ismade to use a hemostatic agent to stop the bleeding

• Pressure on the surface of the hemostatic agent can be applied with the minimallyinvasive instruments to achieve hemostasis

• Subject has a target bleeding site with a SBSS of 1, 2, or 3 (e.g. reflectingminimal, mild or moderate bleeding severities)

Exclusion Criteria:

• The target bleeding site is from a large defect in an artery or vein that requiresvascular reconstruction with maintenance of vessel patency

• Subject is scheduled to undergo surgery on organs other than the liver and itsassociated biliary and vascular system

• Subject is scheduled to undergo a staged liver surgery procedure (e.g., AssociatingLiver Partition and Portal vein ligation for Staged hepatectomy [ALPPS])

• Subject is taking multiple antithrombotic therapies in therapeutic dosage up to thetime of surgery, but allowing exclusive use of acetylsalicylic acid

• Subject has platelet count <100 x 109/L, an activated partial thrombin time of >100s, or international normalized ratio >2.5

• Subject has a total bilirubin level of ≥2.5 mg/dl

• Subject is pregnant, planning on becoming pregnant or actively breastfeeding duringthe 3-month follow-up period

• Subject has a known hypersensitivity to brilliant blue (FD&C Blue #1), porcinegelatin

• Subject who has religious objections to receiving products containing porcine

• Subject has an active or suspected infection at the bleeding site

• Subject in whom the investigational device will be used at the site of a syntheticgraft or patch implant

• Subject has a life expectancy of less than 3 months

• Subject has a documented severe congenital or acquired immunodeficiency

• Subject has had or has planned to receive any organ transplantation

• Subject undergoes surgery with the indication of being a living liver donor

• Subject is currently participating or has participated in another clinicalinvestigation within the past 30 days that may affect the endpoints of the study,such as trials related to the surgical procedure and anti-coagulation

• Subject is not appropriate for inclusion in the clinical investigation, per themedical opinion of the Investigator

• Subject has any incidental (pre- and peri-operative) findings deemed by theInvestigator to potentially jeopardize the safety or welfare of the subject