Purpose
The Authors propose a new method to make segmental resections easier.
Material and methods
Liver resection assisted by RF energy has been shown to be feasible, safe and bloodless. In the present paper the Authors present a modification from the original technique described by Habib et al.
Results
Ten patients underwent an anatomical segmentectomy including resections of segments II & III (n=3), III (n=1), IV (n=2), VI (n=1), VII (n=1) and VIII (n=2). Before starting liver resection, an intra-operative ultrasound (IOUS) was performed to identify the segmental or subsegmental arterial and portal branches feeding the area including the tumour. Coagulative desiccation of these feeding vessels was then induced with the application of a ‘cooled-tip’ RF probe with a 500 kHz- RF Generator (model RFG-3D – Radionics Europe, N.V., Wettdren, Belgium) under US guidance at the level of the vessels. The intrahepatic parenchymal change induced by RF is monitored by using IOUS revealing an absence of Doppler signal and a change in the colour of this area. Following application of RF to destroy the feeding vessels to that segment, there would be an area of marked discolouration on the surface of liver. Finally, liver resection was carried out with the Habib's technique without any form of hepatic inflow occlusion. All the procedures were completed as planned. The resection time ranged from 40 to 60 minutes including the time to destroy feeding vessels with RF. The blood loss during resection was less than 50 mls in all cases. None of the patients required intra or post operative blood transfusion. There was no morbidity or mortality. The length of hospital stay was less than 10 days
Conclusion
Awaiting new and more specific devices to optimize the idea of RF assisted liver resection, the technique utilized have been shown to improve the potential of RF assisted liver resection.