Liver resection using a saline-linked radiofrequency dissecting sealer for transection of the liver

Abstract

s s w ( 7 a s t l t c c c c s L l w u g t n recent years, mortality of hepatic resection has been arkedly reduced with improvement in surgical techiques and perioperative care. As a result, hepatic reection is used increasingly in treatment of various beign and malignant hepatobiliary diseases. Major leeding during hepatic transaction remains a potential azard in hepatic resection and is associated with inreased postoperative morbidity and mortality. Perioprative transfusion for major blood loss is associated with dverse prognosis in patients who undergo hepatic resecion for liver malignancies. Most blood loss in hepatic resection occurs during ransection of the liver. Various techniques of hepatic ransection have been developed, but bleeding still reains a problem in many patients. In addition to the onventional technique of clamp crushing, other techiques, such as cavitron ultrasonic dissector (CUSA), icrowave coagulation, and harmonic scalpel, are being sed in different centers. More recently, Weber and olleagues described use of radiofrequency (RF) ablaion to create thermal coagulative necrosis along the ransection plane, followed by cutting of the liver using scalpel. This method used an RF needle originally deigned for ablation of liver tumors rather than for liver ransection. In this article, we describe a new technique f hepatic transection using a saline-linked RF device pecifically designed for tissue thermocoagulation and issection. Preliminary results in 10 patients with heatic resection using this technique are presented.