Abstract
Various techniques have been reported to reduce blood loss during a parenchymal transection, and the radiofrequency ablation (RFA) technique is one of them. Owing to the charring of the adjacent liver tissue and the inability to use the conventional RFA techniques near major vessels, this study used a radial fiber of RFA. This technical report thus describes a technique to perform parenchymal transection using a radial fiber as well as its advantages and disadvantages. A radial fiber dissipates the energy radially and it has the added advantage of placing along the same and perpendicular axis of the liver parenchyma; it has been used in three patients in this study. The total intraoperative blood loss was 30-50 ml during parenchymal transection, and the intraoperative duration was 120-170 min. Bile leak was noted in one patient, which was then managed using the conventional treatment. Through the present technique, the fiber can be used in the vicinity of major blood vessels and necrosis and charring can be prevented. Although radial fiber has some advantages, it remains in the preliminary stage and requires further validation.
Highlights
Surgical resection is the treatment of choice for primary and metastatic liver tumors [1]
Pai et al [4] first described the use of radiofrequency ablation (RFA) in parenchymal transection; they used a single-probe RFA to reduce intraoperative blood loss
They used a metal probe that has to be inserted perpendicularly into the liver parenchyma, whereas in the technique which we describe probe can be placed horizontally and perpendicular to the liver parenchyma [5]
Summary
Surgical resection is the treatment of choice for primary and metastatic liver tumors [1]. Pai et al [4] first described the use of radiofrequency ablation (RFA) in parenchymal transection; they used a single-probe RFA to reduce intraoperative blood loss. They used a metal probe that has to be inserted perpendicularly into the liver parenchyma, whereas in the technique which we describe probe can be placed horizontally and perpendicular to the liver parenchyma [5]. This study describes a new technique to avoid the charring of the liver tissue and any injury to major biliovascular structures through the use of a radial RFA probe for the ablation of varicose veins. Postoperative bile leak was observed in one patient, which was managed conventionally
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