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Electrode array to minimize blood loss during liver resection: in-vivo results in a porcine model
D. J. Schutt, A. P. O'Rourke, J. A. Will, J. G. Webster, D. M. Mahvi, D. Haemmerich; Medical University of South Carolina, Charleston, SC.
Background: Hepatic resection is currently the standard treatment for liver cancer. During hepatic resection part of the liver containing the tumor is surgically removed. This type of surgery is accompanied by high blood loss of ~1 L. Blood loss is associated with increased complication rates, prolonged hospital stay, and reduced patient survival, especially when transfusion is required. Recently researchers suggested coagulating a tissue slice using radiofrequency (RF) energy before transection through that slice. Methods: We developed a device consisting of a linear array of blade-shaped, 1cm wide radiofrequency (RF) electrodes 1.5 cm apart. Bipolar RF power is applied between pairs of adjacent electrodes, leading to high tissue temperatures between the electrodes that promote coagulation of large vessels (>3 mm) in the resection plane. Rapid switching of applied power between pairs of adjacent electrodes allows simultaneous heating and coagulation of the entire resection plane within 3 - 6 min. Results: In 7 in-vivo trials in a porcine model, resection along a plane pre-coagulated with the device resulted in little (<20 mL) to no blood loss, while coagulating all vessels (up to 4.5 mm diameter in this study). Average treatment time (from placement of the device to transection) was 6.8 ± 0.5 min when 4 electrodes were used, and 11.3 ± 1.2 min when 5-7 electrodes were used. Conclusion: This device may reduce blood-loss related morbidity during resection and reduce treatment time by coagulating all vessels in the resection plane.
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