Use of in- line radio frequency ablation to treat liver surface lesions not amenable with routine RFA probes

Abstract

Radio Frequency Ablation is an established method of treatment for hepatoma arising in a cirrhotic liver where liver resection is not possible or feasible. Tumours less than 4 cms are ablated using RFA probes either percutaneously or laparoscopically. But the flip side of it is that it cannot be used for surface lesions as temperature required to cook the tumour cannot be reached. We employ a novel technique to overcome this shortcoming of conventional RFA probes. In line radiofrequency ablation is a method used for liver parenchymal transection where the transection plane is ablated with special probe (Habib probe). We use the same probe which has a length of 4 cms to ablate the surface lesions in conjunction with the routine umbrella probe. It facilitates ablation of deeper portions with conventional probe and superficial portions with Habib probe. Multiple punctures are required to overlap the ablation zone so that tumour recurrence can be minimised. This requires laparoscopic approach as percutaneous approach cannot facilitate accurate probe placement. In line radiofrequency ablation probe extends the use of Radio Frequency Ablation to surface liver lesions which was hitherto considered as a contraindication. [RFA]